Herpes Zoster (Shingles) and the Eye

Herpes zoster, commonly known as ?shingles,? is caused by the same virus responsible for chicken pox.

After being infected with chicken pox as a child, the virus remains in your body in an inactive or dormant stage. Later in life, the virus can be reactivated if your body?s immune system breaks down. This may happen due to the normal aging process or a number of other factors, including:

  • illness, such as HIV (human immunodeficiency virus);
  • fatigue;
  • emotional or physical stress;
  • poor nutrition;
  • chemotherapy or radiation therapy;
  • certain medications.

What are the symptoms of herpes zoster?

The herpes zoster virus lies in a quiet or dormant period in nerve cells. When the virus is reactivated, the first symptoms are pain, itching and tingling of the skin, followed by redness, numbness and development of a rash. The rash develops into small, fluid-filled blisters called vesicles that later break open and form crusty scabs. The outbreak of shingles typically lasts for a few weeks, but in severe cases, the rash can leave permanent scars, pain, numbness or skin discoloration.

If nerves of the eye are infected with herpes zoster, symptoms may also occur in the eye.

How does herpes zoster affect the eye?

The herpes zoster virus can cause numerous eye problems, including:

A herpes zoster rash develops blisters that break open and form crusty scabs.

  • rash on the upper and lower eyelids;
  • redness, burning and discharge of the conjunctiva (the thin, filmy membrane that covers the inside of your eyelids and the white part of your eye), also known as conjunctivitis or ?pink eye?;
  • dry eyes;
  • increased risk of bacterial infection of the eye;
  • blurred vision and light sensitivity;
  • inflammation, redness, swelling and pain inside the eye, also known as iritis;
  • optic neuritis (inflammation of the optic nerve behind the eye);
  • breakdown of the surface of the cornea.

More severe complications include glaucoma, cataract formation, double vision, and scarring of the eyelids and cornea (the clear, front window of the eye).

How are eye symptoms treated?

Treatment for rash, inflammation, burning and pain may include the following:

  • cool compresses;
  • anti-inflammatory medication;
  • antiviral medication;
  • antibiotic eyedrops;
  • lubricating eyedrops;
  • pain medication.

More serious complications from herpes zoster (corneal scarring, glaucoma, cataracts, double vision, and scarring of the eyelids) will require more extensive treatment by your ophthalmologist (Eye M.D.). Surgery and long-term care of these problems may be necessary.

Is herpes zoster contagious?

Herpes zoster is much less contagious than chicken pox, but it is important for someone with shingles to avoid those who may be more easily infected, such as infants, pregnant women and people with a weakened immune system. It can only be passed to others who have not had chicken pox. The newly infected people will then develop chicken pox, not shingles.

Infections from herpes zoster are likely to recur from time to time, especially in people whose immune systems are weakened. Prompt treatment of the infections is important to reduce the risk of severe complications that may threaten sight.