Ophthalmologists have pointed out an error in the NSW pharmacy trial prescribing guidelines — one that ends up confusing between two different manifestations of herpes zoster.

The error was pointed out in a letter published in The Medical Journal of Australia on Monday by a team from Sydney’s Prince of Wales Hospital and Community Health Services, and UNSW Sydney.

The guidelines, intended to standardise pharmacist management of herpes zoster, erroneously attribute Hutchinson’s sign — a key diagnostic marker for herpes zoster ophthalmicus — to herpes zoster oticus (Ramsay Hunt syndrome) instead.

The error was identified in the trial’s clinical practice guidelines, which state that “vesicles on the nose have been found to be predictive of eye involvement”.