What Is Herpes Zoster (Shingles) of the Eye?
Herpes zoster, commonly known as "shingles," is a viral disease that causes a painful skin rash consisting of small fluid-filled blisters (vesicles) that form scabs and can leave permanent scars. When it involves the region that surrounds your eye, it is called herpes zoster ophthalmicus and can cause serious eye problems including corneal ulcers, inflammation, and glaucoma.
The symptoms of herpes zoster include:
- Blisters around the upper eyelid and forehead on one side
- Burning, throbbing, or itching around the eye
- Skin redness or rash around the eye
- Extreme skin sensitivity to touch
- Eye redness, irritation or tearing
- Blurry vision
The symptoms described above may not necessarily mean that you have herpes zoster. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam.
Varicella zoster, the same virus that causes chicken pox, is responsible for herpes zoster. The virus stays in your body and can resurface years later as shingles, causing skin rash and pain. Patients who have never contracted the virus (never had chicken pox) cannot get shingles. The herpes zoster vaccine can be given to help decrease the risk of developing herpes zoster. Eye problems from herpes zoster may appear at the same time as the skin rash or weeks after the lesions have disappeared.
The reasons for virus reactivation is not known, but older age, stress, illness, and a weakened immune system may play a role.
Tests and Diagnosis
Herpes zoster usually can be diagnosed by a routine exam with your physician. If the rash is present near the eye, you should see your ophthalmologist to rule out viral activity in the eye. Special imaging or other testing is rarely necessary.
Treatment and Drugs
Systemic treatment by a primary care doctor typically involves control of pain and prevention of further skin infection. An oral antiviral medication usually is prescribed. Although most people recover from the skin rash without complications, some people continue to have pain for years. It is important to see an ophthalmologist because rare but potentially serious eye complications can occur. Treatment is tailored to the specific problem.
A Kellogg Eye Center study found corneal transplants are an effective treatment for ocular complications of shingles, which can reduce vision to legal blindness if the painful rash spreads to the eye.
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Reviewed by Christopher T. Hood, M.D.