Ophthalmic zoster
The regional formulary will not cover all eventualities for infections medicines choices. As with any condition; patient specific factors and sensitivities need to be considered. Please consider this regional formulary advice alongside any relevant local Board guidelines.
For general guidance on administration of drugs to the eye and on control of microbial contamination of eye drops, please see the ‘General information on eye drops’ recommendations.
Treat with oral aciclovir or valaciclovir, with or without ganciclovir eye gel.
800mg 5 times daily for 7 days.
1000mg 3 times daily for 7 days (3000mg total daily dose).
1000mg 3 times daily for 7 days (3000mg total daily dose).
Ganciclovir used where on examination there is ocular epithelial involvement.
Apply 5 times a day until healing complete, then apply 3 times a day for a further 7 days, treatment does not usually exceed 21 days.
Prescribing Notes:
- Oral aciclovir or valaciclovir should be prescribed immediately for ophthalmic zoster.
- During treatment with ganciclovir eye gel, women of childbearing age should use effective contraception, and men with partners of childbearing age should be advised to use barrier contraception during and for at least 6 months after treatment.
- Valaciclovir is substantially more expensive than aciclovir, therefore it should be used where aciclovir is ineffective or not tolerated.
History Notes
30/07/2026
Regional formulary chapter launched.