We conducted a prospective study of 100 consecutive Ethiopian patients
with herpes zoster ophthalmicus (HZO); this study revealed a high inc
idence of HZO among the young (mean age, 35 years). Eighty-one (95%) o
f 85 patients who underwent serological testing were seropositive for
antibodies to human immunodeficiency virus (HIV). Unlike previous inve
stigators, we found a marked increase in the incidence and severity of
eyelid (25%) and ocular (78%) complications as well as postherpetic n
euralgia (55%). Visual loss occurred in 56% of the cases. Lack of medi
cation, delay in presentation, severity of HIV-related HZO, and applic
ation of herbal medications adversely affected the outcomes for these
patients. We conclude that all patients with HZO, especially those you
nger than 45 years of age, should be screened for HIV infection. Becau
se HZO is a vision-threatening problem, all health care workers should
become aware of its management.