How Does Shingles Affect The Eyes
Although its not common, about 10 to 20 percent of people with shingles also get it in and around the eyes this is called ophthalmic herpes zoster. Shingles in the eyes can lead to scarring of the cornea, cataracts, glaucoma, and even vision loss. If the virus infects the nerves of the eye, symptoms can include:
- Redness or rashes in and around the eye
- Tingling in the face
- Pain, throbbing and swelling
- Swelling of the optic nerve
Shingles Of The Eye Can Cause Lasting Vision Impairment
- By Miriam Barshak, MD, Contributor
Shingles, or herpes zoster, is a viral infection known for its characteristic painful, burning, or itchy rash. This rash appears along a particular affected nerve, for example in a band on one side of the chest or abdomen that extends around to the back. In fact, the name shingles comes from cingulum, the Latin word for girdle, belt, or sash.
Shingles is caused by reactivation of the varicella zoster virus, the virus that causes chickenpox. After the initial chickenpox infection resolves the virus lives on in nerves all over the body, but is kept in check by the immune system. The risk of shingles therefore increases with any process that can weaken the immune system, including age, illness, and immune-suppressing medications. About one million cases of shingles occur in the US each year.
Up to 20% of shingles episodes involve nerves of the head, where the infection can affect various parts of the eye, including the eyelid, the eye surface, and the deeper portions of the eye. Viral infection of the eye can cause pain, drainage, redness, and sensitivity to light. In some cases it can lead to vision impairment, including blindness.
Diagnosis Of Shingles In The Eye
Your doctor should be able to diagnose shingles just by looking at the rash on your eyelids, scalp, and body. Your doctor might take a sample of fluid from the blisters and send it out to a lab to test for the varicella-zoster virus.
An eye doctor will examine:
- help the rash fade more quickly
Starting the medicine within three days after your rash appears can help you avoid long-term shingles complications.
To reduce swelling in your eye, your doctor might also give you a steroid medicine in the form of a pill or eye drops. If you develop postherpetic neuralgia, pain medicine and antidepressants can help relieve the nerve pain.
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When To Seek Care
Early shingles symptoms, such as pain or flu-like feelings, are not obvious signs of a shingles outbreak.
Once a rash appears, you should see your primary care physician or a dermatologist. A trained eye can often diagnose shingles by visually inspecting the rash.
If you have shingles, you may never experience the extreme pain that can often come with it. You may only feel itching and some minor discomfort.
Even without the painful symptoms of shingles, its recommended that you see a healthcare professional and start antiviral treatment within 72 hours of a rashs appearance.
Its especially important to seek prompt medical care if a rash forms near one or both eyes. Shingles in the eye may cause permanent vision loss.
When Should I Get The Shingles Vaccine
The current shingles vaccine is a safe, easy, and more effective way to prevent shingles than the previous vaccine. In fact, it is over 90% effective at preventing shingles. Most adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses. You can get the shingles vaccine at your doctors office and at some pharmacies.
You should get the shingles vaccine if you:
- Have already had chickenpox, the chickenpox vaccine, or shingles
- Received the prior shingles vaccine called Zostavax
- Dont remember having had chickenpox
Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.
You should not get vaccinated if you:
- Currently have shingles
- Are sick or have a fever
- Had an allergic reaction to a previous dose of the shingles vaccine
If you are unsure about the above criteria or have other health concerns, talk with your doctor before getting the vaccine.
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How Eye Shingles Are Treated
You do not have to endure shingles. With the help of your doctor, you can overcome the discomfort and help the outbreak to heal. You can also take some steps to reduce the frequency and severity of your outbreaks.
The key is to get help within three days of the start of an outbreak. That is the moment at which your immune system is still strong but could use a little boost. Antiviral medications can tamp down the virus and send it back to the nerve root, so you will feel a bit more comfortable.
You will still be at risk for future outbreaks, as shingles can’t be cured. But the treatment can keep the excruciating pain and damage at bay.
Your doctor may ask you to spend a few days in the hospital. You will get around-the-clock care for your outbreak, and your doctor can watch the infection carefully and step in if sight-stealing complications appear.
When you are released to your home, there are plenty of things you can do to ease your discomfort. The American Academy of Ophthalmology recommends:
- Cool compresses. A moist, damp towel placed over your closed eyes can relieve some of your pain.
- Painkillers. If your doctor agrees, you can use medications like aspirin to ease distress.
- Eye drops. Your doctor may suggest soothing drops to help your tissues knit back together.
Shingles In The Front Of The Eye
Shingles can affect the cornea, the curved, transparent dome of tissue at the front of the eye. This is called keratitis, and it can occur as a complication of herpes zoster ophthalmicus , which refers to shingles with a rash that typically involves one side of the upper face, forehead, and scalp. More than half of patients with HZO may have keratitis.
If you have shingles involving the upper face, forehead, or scalp area, it is important to see an ophthalmologist for a formal eye examination, whether or not you notice any eye symptoms. Keratitis usually develops within one month of the shingles rash and can lead to numbness of the cornea, scarring, additional infections, and more corneal damage, which can ultimately cause blindness.
HZO, like episodes of shingles on other areas of the body, is typically treated with oral antiviral medications to address the underlying viral infection. Treatment decreases the risk of later eye complications by about 40% to 60%. When started within 72 hours of the onset of symptoms, antiviral treatment also reduces the overall severity of the infection and the risk of post-herpetic neuralgia, a form of long-term pain that can occur after an episode of shingles.
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Risk Factors For Shingles
Once youve had chickenpox as a child, youre at risk of getting shingles later in life. The virus stays dormant, or asleep, in your body. It hides out in nerve cells near your spinal cord, but it can become active again when youre older.
Youre at increased risk of getting shingles if you:
- had chickenpox as a child
- are age 50 or older because your immune system weakens as you age
- have a weakened immune system because of a disease like cancer, HIV infection, or AIDS
- take medicine that weakens your immune system, such as chemotherapy or radiation for cancer, or stops your body from rejecting a transplanted organ
Shingles is especially serious in some groups of people, including:
How Long Does Shingles In The Eye Last
Shingles in the eye can last for up to a few months. Your opththalmologist/eye care professional 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.
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When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
How Is Shingles In The Eye Diagnosed
Your ophthalmologist will be able to diagnose shingles in the eye just by looking at the rash on your eyelids and surrounding areas. They might 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.
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Shingles In The Eye: Causes Symptoms Prevention & Treatments
If youve had the chickenpox virus as a child, you could develop shingles later in life. Shingles can appear anywhere on your body and cause complications, including in your eyes.
Shingles in eye areas can affect vision, along with the other painful and potentially dangerous symptoms that come with the virus. If you have symptoms of shingles, talk to your doctor for treatment options.
How Is Shingles Diagnosed
Your healthcare provider will do a complete physical exam and ask about your medical history, specifically about whether you have ever had chickenpox.
Your healthcare provider will likely know right away that it is shingles based on the unique rash. The rash usually appears one area on one side of the body or face. It appears as red spots, small fluid- or pus-filled vesicles, or scabs.
The healthcare provider may also take skin scrapings for testing.
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What You Should Know About Shingles
You may not remember having the itchy, painful welts caused by chickenpox. But according to the Centers for Disease Control and Prevention , 99.5 percent of people born before 1980 were infected at one point or another. Anyone who has been infected is at risk for shingles.
When chickenpox infections fade, the virus that caused them does not. Chickenpox is caused by the varicella-zoster virus , and it’s a member of the herpes family. Like most herpes-based illnesses, VZV never really goes away. Instead, it lies dormant within your body.
VZV rests within your nerves, and during a shingles outbreak, the virus triggers inflammation and pain along a nerve band. The CDC says one in three people will get shingles. Most have just one outbreak, but some have repeated problems.
Mayo Clinic says shingles can cause more than pain. The condition can also cause:
- Persistent fatigue.
- Sensitivity to light.
Typically, people with shingles will experience blisters along just one small area that wraps around the torso. But any part of the body served by nerves can get hit with shingles. Symptoms last for about two weeks before fading away.
What Are Shingles In The Eye
The varicella-zoster virus causes shingles. In many people, the varicella-zoster virus remains dormant, while in others, it activates later. This virus can appear as shingles, a painful rash, several decades after you first encountered chickenpox.
In 10-20% of people who encounter shingles, the rash appears on or around the eye. When the shingles rash appears in the eye, it becomes herpes zoster ophthalmicus, named for its location. Most of the time, shingles do not appear in the eye, but you can have shingles on the eye and nearby facial areas as well as more common parts of your body, like your back or chest.
While most people recover fully after having shingles, eye shingles do present unique problems. The virus can cause problems like vision loss and scarring. It can also have longer-lasting effects on anyone who has a compromised immune system.
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Shingles Of The Eye: Complications Symptoms And Treatment
Medically reviewed by Tina Patel on 6th September 2022
Shingles of the eye are also known as ophthalmic herpes zoster or herpes zoster ophthalmicus. It is a viral infection which causes a painful, blistering 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.
Check If You Have Shingles
The first signs of shingles can be:
- a tingling or painful feeling in an area of skin
- a headache or feeling generally unwell
A rash will appear a few days later.
Usually you get the shingles rash on your chest and tummy, but it can appear anywhere on your body including on your face, eyes and genitals.
The rash appears as blotches on your skin, on 1 side of your body only. A rash on both the left and right of your body is unlikely to be shingles.
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What Are Eye Shingles
Eye shingles is a painful rash of the skin around the eye. It typically affects the forehead and skin of the upper lid. It also can affect the side or tip of the nose. If not quickly daignosed and treated, shingles in the eye can cause permanent damage to your vision.
Shingles on the face and eye is caused by the same virus that causes chickenpox. Shingles can be limited to the area around your eye or it can cause a painful red rash elsewhere on your body.
Over the past six decades, cases of shingles have been on the rise.
The number of cases of eye shingles in the United States tripled from 2004 to 2016, according to University of Michigan’s Kellogg Eye Center.
Researchers found that people over age 75 have the greatest risk. Whites and women also present with a higher incidence of eye shingles.
What explains this increase? Weakening of the immune system from chronic diseases and stress are factors.
Dr. Christopher Rapuano, MD, chief of Cornea Service at Wills Eye Hospital, one of the top U.S. ophthalmic specialty hospitals, says few Americans are getting vaccinated for shingles, which is the best way to avoid the disease and protect your eyes.
Shingles can cause bad things to happen to the eyes, and some of those things can happen even with good treatment, he says.
What Causes Shingles On The Face
Herpes zoster occurs when the chickenpox virus gets reactivated. After someone has a breakout of chickenpox, the virus remains in a dormant state in certain nerves and it can stay that way for many years. Shingles are more common in people with weak immunities and in older people.
Medical researchers acknowledge that they understand fully what triggers the virus, although compromised immunity is present in almost all patients. And there is no hard and fast reason why some people get shingles on the face.
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How Can I Take Care Of Myself
- Take a pain-relief medicine such as acetaminophen. Take other medicine as prescribed by your healthcare provider.
- Put cool, moist washcloths on the rash.
- Rest in bed during the early stages if you have fever and other symptoms.
- Try not to let clothing or bed linens rub against the rash and irritate it.
- You develop worsening pain or fever.
- You develop a severe headache, stiff neck, hearing loss, or changes in your ability to think.
- The blisters show signs of bacterial infection, such as increasing pain or redness, or milky yellow drainage from the blister sites.
- The blisters are close to the eyes or you have pain in your eyes or trouble seeing.
- You have trouble walking.
Early & Late Symptoms
The symptoms in the early stages of shingles in the eye include
- Tingling, or stabbing pain
- You are also likely to have itchiness on the skin around your eyes
- Burning sensation around your eyes also results from itchiness
- For children or teenagers, fever is also a common sign
- You are also likely to have extra light sensitivity
Late symptoms include the following
- An itchy rash around the eye and on your forehead
- Painful blisters on the eye lids
- Eye lid may be paralyzed
- Numbness of the skin on the forehead
- Frequent Tearing and Watering of the eyes
- On rare occasion, you may have blurry vision
- Irritation and swelling of the eyelids
If you have blurred vision after treating shingles, it is advisable that you see your doctor. There is a possibility that there is an underlying condition which causes the blurry vision. The blisters that form around your eyes may change the color to yellow.
As mentioned above, blisters are one of the symptoms of shingles in the eye. At a later stage, these blisters may begin to ooze. This may lead to formation of scabs around the eye.
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Is Ocular Shingles Contagious
Ocular shingles are not contagious despite stemming from the same virus which causes chickenpox .
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.