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Ocular Shingles: Symptoms, Complications and Treatments
Ocular shingles are also known as ophthalmic herpes zoster or herpes zoster ophthalmicus. It is a disease which causes a painful rash to appear in or around the eye. Shingles commonly affect the body more than the eyes and are caused by the varicella-zoster virus, which is the same virus responsible for chickenpox.
Can you get chickenpox in your eye?
While you can't get chickenpox in your eye, the same virus which causes chickenpox can cause shingles which you can get in your eye.
Once chickenpox has gone away, the virus lays dormant in the body and can reactivate at any time, causing shingles.
Shingles can affect the facial nerves causing one to experience eye-related symptoms such as shingles in the eye.
What are symptoms of shingles in the eye?
Shingle symptoms include a blistering rash on the eyelids, which can lead to an eyelid infection. It may accompany a skin rash or show up weeks after the blistering skin rash disappears. Some may only experience ocular shingles without a shingles rash on the skin.
Other symptoms of shingles include:
- Burning sensation in the eye
- Throbbing pain in the eye
- Redness in and around the eye
- Watery eyes
- Blurry vision
- Sensitivity to light
- Eye irritation
- Swelling on your eyelid, retina or cornea
How long does shingles in the eye last?
Shingles in the eye can last for up to a few months. Your doctor should check your eyes every few days at the beginning stages. Once the infection has been treated, they may be required to see you every 3-12 months to monitor your vision and check for scarring or glaucoma.
Is ocular shingles contagious?
Ocular shingles are not contagious despite stemming from the same virus which causes chickenpox (which is contagious).
Can you catch shingles?
You cannot catch shingles; however, you can spread the varicella-zoster virus to somebody who has never had chickenpox, and this can cause them to develop chickenpox.
Once one has contracted the varicella-zoster virus, it will stay in their body forever and can activate again years later, resulting in shingles or/and ocular shingles.
The virus only spreads through contact with unscabbed shingles blisters. It does not spread through saliva.
Complications of shingles in the eye
Shingles can cause complications such as pain, even after the rash has cleared up due to nerve damage caused by the virus.
Shingles can also cause swelling of the cornea, leaving permanent scars and swelling of the retina, which can increase the pressure inside the eye and lead to glaucoma.
In addition to this, shingles in the eye can result in:
- Corneal ulcers
- Scarring
- Acute retinal necrosis, which can lead to blindness
It's important to treat ocular shingles immediately to avoid further long-term complications such as vision loss. If you suspect you have shingles, you should visit your primary care doctor right away.
How is shingles in the eye diagnosed?
Your doctor will be able to diagnose shingles in the eye just by looking at the rash on your eyelids and surrounding areas. Sometimes they will take a sample of the blister fluid to examine for the varicella-zoster virus.
They will also examine your cornea, retina, lens and other parts of your eye, looking for swelling and damage that may have been caused as a result of the virus.
Treatment of shingles in the eye
Treatment with antiviral medication is most commonly used by doctors when shingles affect the eyes. It can come in a liquid or tablet form.
Antiviral medication can treat shingles by:
- Preventing the virus from spreading
- Helping the blisters heal
- Speeding up the fading of the rash
- Relieving pain
If one has a weakened immune system, they may be admitted to the hospital for intravenous antiviral medication.
Shingles in the eye can also be managed with steroid eye drops to reduce swelling.
It is best to prevent shingles in the first place by getting the shingles vaccine.
Risk factors for shingles
Shingles in adults are typically more common than in children. It is especially common in people aged 50 and older. While it's unknown as to why the varicella-zoster virus reactivates, risk factors include:
- Being older
- Stress
- A weakened immune system
- Being ill
