Shingles

Shingles ophthalmicus, also known as herpes zoster ophthalmicus, is a viral infection that affects the eye and the surrounding area. It is caused by the varicella-zoster virus, which is the same virus that causes chickenpox. After a person recovers from chickenpox, the virus can remain dormant in nerve cells and become reactivated later in life, causing shingles.

Key points about shingles ophthalmicus:

1. Symptoms: Shingles ophthalmicus primarily affects the ophthalmic branch of the trigeminal nerve, which supplies sensation to the forehead, eye, and surrounding area. Symptoms may include:

   • Severe pain, usually on one side of the forehead or around the eye.

   • Rash that develops a few days after the pain, with clusters of fluid-filled blisters that can be very painful and may eventually crust over.

   • Redness and swelling of the eyelids.

   • Itching and irritation.

   • Eye redness.

   • Sensitivity to light (photophobia).

   • Blurred vision or other visual disturbances.

2. Complications: Shingles ophthalmicus can lead to several serious complications if not promptly treated:

   • Ocular Herpes Zoster: Infection of the cornea or other parts of the eye can lead to scarring and vision loss.

   • Postherpetic Neuralgia: After the rash has healed, some individuals may experience persistent nerve pain in the affected area, known as postherpetic neuralgia.

   • Conjunctivitis: Inflammation of the conjunctiva (conjunctivitis) can occur.

   • Glaucoma or Uveitis: In some cases, shingles ophthalmicus can lead to inflammation of the eye's internal structures, potentially causing glaucoma or uveitis.

3. Diagnosis: Diagnosis is often based on clinical symptoms, including the characteristic rash and severe pain in the ophthalmic region. An eye care professional may also perform an eye examination to assess any potential eye involvement.

4. Treatment:

   • Early treatment is crucial to prevent complications. Antiviral medications, such as acyclovir, valacyclovir, or famciclovir, are typically prescribed to reduce the severity and duration of the infection.

   • Pain management: Over-the-counter pain relievers or prescription medications may be used to manage pain.

   • Eye care: If the eye is affected, an ophthalmologist will closely monitor and manage any ocular complications.

5. Prevention: The shingles vaccine, Shingrix, is recommended for individuals aged 50 and older to prevent shingles and its complications. The vaccine has been shown to reduce the risk of shingles and postherpetic neuralgia.

If you experience symptoms of shingles ophthalmicus, especially if the eye is involved, it's important to seek immediate medical attention from an eye care professional or a healthcare provider. Prompt diagnosis and treatment are essential to minimize the risk of complications and preserve eye health.