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.
Triggers Of Shingles In The Eye
Below is a brief summary of the common triggers of shingles in the eye
Age
As you continue to grow older, your immune system continues to become weaker. If you have varicella zoster from shingles in the past, your chances of getting shingles increases as you advance in age.
Old people need to be very well taken care of so that there immune system stays strong enough for shingles not to erupt.
Viral diseases
Another trigger for shingles is viral diseases such as HIV/AIDS. When you have a viral disease, your immune system is totally weakened and you are likely to get shingles. The shingles in the eye in such a case will always come back following treatment.
Stress
Stress increases the chances of getting shingles although indirectly. When you are stressed, your appetite levels drop greatly. This will definitely result to a weakened immune system since you are likely to skip your meals.
Strong medication
There are some medications that are too strong for your immune system to totally handle them. Such medications make you vulnerable to attacks such as those by shingles.
For that reason, if you are taking very strong medications that are probably making it difficult for you to eat you should be monitored closely by your doctor.
Shingles Rash In The Eyes
Ophthalmic shingles, or herpes zoster ophthalmicus , is when the shingles rash is in and/or around the eye. It is a severe variant that affects 20% of people with the infection.
If you develop a shingles rash near your eye, contact your healthcare provider right away.
lauraag / Getty Images
HZO usually appears within two to four weeks after a shingles rash starts. People who have a compromised immune system, such as those with HIV/AIDS, are at higher risk for developing this.
All parts of the eye can be affected. For example:
- You can develop blisters around the eye that may cause the eyelids and surrounding area to swell.
- The corneaâthe transparent part over the front of the eyeâcan be affected, causing calcification .
- Blood vessels in the eye could become more pronounced blood flow to the eye could be impacted.
To reduce your risk of long-term eye complications, contact your healthcare provider right away if you have a shingles rash on your face.
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What Causes Shingles In The Eye
The varicella-zoster virus, the virus that causes chickenpox, lives in the nerves of people who have previously had chickenpox. It becomes herpes zoster ophthalmicus when it reaches the eye, and it can cause severe pain along with the notorious rash that accompanies shingles on other areas of the body.
The shingles virus does not always activate in people who have had chickenpox. When it does, the shingles rash most often appears along the back, ribs, and chest areas. Occasionally, it will show up in other areas, like the face or legs.
According to experts, the resulting weakened immune systems and stress have caused increased shingles cases, tripling them from 2004 to 2016. You cannot predict whether you will have eye shingles since the virus can travel over your body and appear in different areas.
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:
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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.
How Is Shingles Treated
There is no cure for shingles, but antiviral medicine may relieve the symptoms and help prevent complications. See your doctor for a prescription of antiviral medicines as soon as possible after symptoms develop. Treatment should be started within 3 days of the shingles rash appearing.
If you are pregnant, talk to your doctor about whether antivirals are right for you.
Over-the counter medicines, such as paracetamol and non-steroidal anti-inflammatories, can be used for pain relief. If over-the-counter medicines are not controlling your pain, your doctor may prescribe other medicines.
There are several things you can do to help manage the condition. They include the following.
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When To See A Doctor
Chronic intercostal neuralgia can greatly impact a persons quality of life.
The condition can be extremely uncomfortable. Chronic pain from intercostal neuralgia can also lead to reduced movement and poor sleep quality. It can also make it difficult for a person to breathe.
Also, intercostal neuralgia has some symptoms in common with other potentially serious health conditions. These include:
For this reason, it is important for anyone with prolonged or acute intercostal neuralgia to see a doctor immediately.
People should also see a doctor if they experience other symptoms of shingles.
Other Signs And Symptoms Of Shingles
While shingles commonly causes pain, headache, and itching, it can also present a range of other symptoms.
The severity of the symptoms will vary from person to person. Some people may have mild symptoms, whereas others may feel intense pain.
Other symptoms of shingles include:
- sensitivity to light
- fluid-filled blisters
Seek immediate medical care if you experience symptoms of shingles.
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Preventing Shingles In The Eye
When it comes to shingles and especially ocular shingles prevention is the best medicine.
Fortunately, there are two shingles vaccines:
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Shingrix A fairly new vaccine, Shingrix is recommended for adults ages 50 and over. You get Shingrix in two doses two to six months apart, and its more than 90% effective in protecting you from shingles and post-herpetic neuralgia. Protection stays strong for at least four years after you get vaccinated.
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Zostavax An older vaccine for shingles, Zostavax is a live vaccine that is less effective but may be used in healthy adults ages 60 and up if theres a reason they cant have Shingrix administered. For example, someone who is allergic to a component of Shingrix may opt for Zostavax.
The availability of a newer, more effective vaccine should prevent even more shingles outbreaks. We recommend the vaccine for all of our patients, Dr. Rapuano says.
WORRIED YOU MIGHT HAVE EYE SHINGLES ?Find an optician near you and schedule an appointment.
Page published on Sunday, 24 May 2020
Page updated on Wednesday, 2 February 2022
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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.
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Is Herpes Zoster Preventable
There are two available vaccines that can help prevent shingles. Doctors recommend the vaccines for people over the age of 50, even if they have had shingles before.
Discuss the vaccines with your healthcare provider about the best time to receive your shingles vaccine. Sometimes they will include the vaccine as part of an annual physical.
Can You Get Shingles In The Eye
Its most common to get the shingles rash on your chest, back or legs but you can get shingles on the face and eye, Rapuano says. About 15% of cases involve shingles in the eye area, he says.
However, theres a difference between having shingles around the eye and having shingles in the eye, which doctors refer to as eye involvement, Rapuano says. A patient can have shingles around the eye area without the eye itself being involved, he says.
About half of people who have shingles on the forehead or nose will also have eye involvement.
Ocular shingles typically occurs in one eye on the same side of the face as the rash. It typically occur after the shingles rash on the body has resolved, Rapuano says.
A patient who has had shingles on the face may feel like theyre healing well but then notice a symptom such as redness in the eye. When this happens, patients need to see an eye doctor right away, Rapuano says.
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Shingles In Eyes Pictures
With shingles in eye, most people will have a blistering rash form on eyelids, forehead and in some cases on the tip and side of the nose. The rash can appear the same time as the blister or after the blisters have gone away.
Shingles will often be accompanied by other symptoms such as redness around eye, watery eyes, and in some cases blurry vision. Here are some pictures of how eye shingles will look like.
Can You Prevent Shingles
Shingles are caused by an outbreak of the chickenpox virus. You have two avenues to follow that lead to prevention, including avoidance and vaccines.
If you’ve never been exposed to the chickenpox virus, prevention is critical. That means you should avoid:
- Anyone with active chickenpox. The puss inside the chickenpox holds the virus, and it’s very contagious. Steer clear of anyone who has been diagnosed. Chickenpox is considered to be more contagious than shingles.
- Anyone with shingles. You can get shingles from someone with an outbreak, although it’s rare. If you’ve never been exposed, do not take a chance.
If the outbreak is in the blister phase, the person is contagious. Once the blisters crust over, the person is no longer contagious. If the person keeps their rash and blisters covered, the risk of spreading the virus is low.
Some people are more susceptible to contracting the virus. This includes people with certain autoimmune conditions as well as those with other conditions that suppress the immune system. People who take certain immunosuppressive medications are also at a higher risk.
Adults 50 and older can use a vaccine for protection. Experts agree that the vaccine is not perfect, and some people who get it still get sick later. But it can reduce your risk of an outbreak. Your doctor can tell you whether you should get it and when.
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If You Have Shingles Symptoms Get Treatment Now And You May Avoid Permanent Nerve Pain
Shingles, a viral infection of the nerve roots, affects 1 million people in the U.S each year. Most people recover from their bout, but for as many as 50% of those over age 60 who have not been treated, the pain doesnt go away. It can last for months, years, or even the rest of their lives.
These people have whats called postherpetic neuralgia , the result of the shingles virus damaging the nerves of the skin. In some cases, the pain is mild. In others, even the slightest touch from clothing or even a breeze can be excruciating.
PHN causes a great deal of suffering and high social costs, says Robert H. Dworkin, PhD, a professor in the department of anesthesiology at the University of Rochester Medical Center in Rochester, N.Y. It can severely disrupt peoples lives.
But the good news is that there are drugs that can help treat and even prevent PHN, and doctors are learning more about who is at greatest risk of developing this debilitating condition.
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What You Can Do About Nerve Pain That Lingers After Shingles
Chronic pain that continues after a case of shingles is called postherpetic neuralgia . It is estimated that about 20% of patients will experience this type of nerve pain as a complication of shingles.
Those who have had chickenpox are at risk of developing shingles later in life. People who develop PHN are generally age 60 and older. Although there is no cure for PHN, there are several methods of pain management that can ease symptoms. Fortunately, the type of pain that arises from postherpetic neuralgia improves over time.
Neuralgia affects the nerves, causing structural and functional damage. It can feel like a stabbing or burning pain that radiates along the affected nerve.
Neuropathic pain is not caused by an external injury or stimuli but originates from inside the nervous system. When the herpes-varicella zoster virus is reactivated in the form of shingles, scar tissue forms alongside nerves, creating pressure, and sending pain signals to the brain.
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Treatment Of Herpes Zoster Ophthalmicus
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Antiviral drugs taken by mouth
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Corticosteroid eye drops
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Eye drops to keep the pupil dilated
As with shingles anywhere in the body, early treatment with an antiviral drug such as acyclovir, valacyclovir, or famciclovir can reduce the duration of the painful rash. When herpes zoster infects the face and threatens the eye, treatment with an antiviral drug reduces the risk of eye complications.
Corticosteroids, usually in eye drops, may also be needed if the eye is inflamed.
Eye drops, such as cyclopentolate or atropine, are used to keep the pupil dilated, to help prevent a severe form of glaucoma, and to relieve pain.
Shingles And Nerve Paths
Shingles is caused by a reactivation of the virus that causes chickenpox. Only people whove had chickenpox or chickenpox vaccines can develop shingles. Having a chickenpox vaccine can lead to shingles because the vaccine contains the virus that causes chickenpox.
Shingles isnt contagious, but people who have not had chickenpox can develop chickenpox if they come in contact with open blisters of somebody with shingles.
After your body fights off a chickenpox infection, the herpes zoster virus remains dormant in your cranial nerves and spinal ganglia until it becomes reactivated. Spinal ganglia are nerve cells that connect your spinal cord to nerves in your body and limbs.
The virus reactivates when your immune system is no longer able to suppress it. Reactivation most commonly occurs in older adults because the immune system tends to get weaker with age, as well as in people with suppressed immune systems.
Once the virus is active, it usually spreads down sensory nerve fibers that lead from your spinal cord to your skin. These nerves carry sensory information like feelings of pain, itchiness, or pressure from your skin to your spinal cord and brain.
Once the virus gets to the end of these sensory nerves, it reaches your skin and usually leads to a rash. This rash often shows up in one or two nearby areas of skin called dermatomes.
A dermatome is an area of your skin where the sensation is supplied by one spinal nerve.
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Who’s At Risk For Shingles
Anyone who has ever had chickenpox can get shingles, but the risk increases with age. People older than age 60 are up to 10 times more likely to get shingles than younger people. Other factors that increase your risk include:
- Some cancer medicines
- A weak immune system from illnesses such as cancer or HIV
A quarter of adults will develop shingles at some point, and most are otherwise healthy.