Herpes Zoster Eye Infection

What is a herpes zoster eye infection?

Herpes zoster, or shingles, is a disease caused by the same virus that causes chickenpox. You can only develop shingles if you have had chickenpox at some point in your life.
Shingles causes painful blisters along the nerves on one side of the body, and it can spread to the face and eyes, where the virus can cause serious damage. Early detection and prompt care help reduce the likelihood of serious complications from a herpes zoster eye infection.

What causes it?

If you have ever had chickenpox, you are at risk of developing shingles later in life. After you recover from chickenpox, the virus remains in your body, and it may become active again if your immune system is weakened by:

• Ageing: people over 50 are more prone to developing shingles.
• AIDS or Hodgkin’s lymphoma
• Chemotherapy or radiotherapy
• Taking certain medications, such as steroids
• You are also at higher risk of developing shingles if, in recent days, weeks or months:
  • You have been under considerable stress
  • Your diet has been consistently poor
  • You have had a great deal of sun exposure

A person with shingles can pass chickenpox on to someone who has never been in contact with the chickenpox virus. The virus is transmitted through contact with the blisters, which stop being infectious once they dry up and scab over.

What are the symptoms?

The symptoms of a herpes zoster eye infection generally appear in three stages:

• Early stage: Sharp pain, itching or a burning sensation on the forehead, eyelids, or the tip or sides of the nose.
• Outbreak stage: Around 3 to 5 days after the early symptoms begin, blisters may appear on the forehead, on or inside the eyelids, or on the edge or sides of the nose. The blisters start out clear, with redness around their base. Over 5 to 7 days, the clear blisters fill with pus or begin to bleed. The virus may affect only the skin of the face, or it may cause obvious symptoms in the eyes, such as:
  • Swelling of the eyelids
  • Red, sore, watery eyes
  • Sensitivity to light
  • Blurred vision
  • A feeling that something is in your eye or under the eyelid
• Some people develop symptoms only in the eyes, without any blisters.
• Recovery stage: The blisters begin to crust over and heal within 1 to 3 weeks, and the discomfort or irritation usually settles within 3 to 5 weeks. If the virus has caused nerve damage, you may experience pain, numbness or tingling for months, or even years, after the rash has healed.

How is it diagnosed?

Your ophthalmologist will ask about your medical history and symptoms, and will examine your skin and eyes. If your blisters are producing fluid, samples may be sent to a laboratory to test for the virus.

How is it treated?

Certain medicines are effective in treating herpes zoster eye infections. Your ophthalmologist may:
Prescribe antiviral medication to ease discomfort and help the blisters heal.
Prescribe steroid medication to ease discomfort and reduce swelling.

How can herpes zoster eye infections be prevented?

Most children are vaccinated against the chickenpox virus. If you have never had chickenpox, you can have a vaccine to protect yourself from the disease.
There is also a shingles vaccine, available to people aged 50 and over and strongly recommended for those aged 60 or older.
The vaccine can help you avoid shingles altogether or reduce its symptoms, but it cannot be used to treat shingles once you have the disease.
If you have not been vaccinated against chickenpox and have never had the disease, try to stay away from anyone who may have an active chickenpox infection. If you are pregnant, do not go near anyone with chickenpox or shingles.