Shingles in the Eye

Varicella zoster virus is the causative agent of chickenpox. Once a person contracts chickenpox after being exposed to varicella zoster, this virus lies in an inactive form in the nerve roots near the spinal cord. Shingles, which is medically referred to as herpes zoster, is a medical condition that occurs when the varicella zoster virus gets reactivated. Shingles is basically an infection of a nerve. As the virus travels along the affected nerve, it causes inflammation thereby giving rise to itching, burning sensation and development of rashes. If the virus travels along the nerve that connects to the eye, one would suffer from ophthalmic shingles or shingles in the eye. Only those who have had an episode of chickenpox previously can develop shingles. Here's some information on the circumstances under which one may contract shingles in the eye along with ways to treat the same.

Shingles in the Eye: Causes

Chickenpox is often viewed as a childhood infection since a majority of people develop this infection during childhood. Even after the signs of the infection disappear, this virus remains dormant in the spinal nerve roots. More often than not, high levels of stress can cause the dormant virus to escape from the nerve cells. The reactivation of the dormant virus is more likely to occur in case of people with a compromised immune system.

Once the virus gets reactivated, it causes inflammation along the path of the affected nerve branch. The part of the body where the symptoms appear corresponds to the dermatome or the distribution of the major sensory nerve on the skin. Shingles in the eye would occur in event of the involvement of the ophthalmic branch of trigeminal nerve, which is a sensory facial nerve. If trigeminal nerve is affected, one may experience itching, pain and a burning sensation on the forehead, eye, nose or cheek. Since the trigeminal nerve dermatome extends across the eye, one could suffer from eye problems if this dermatome is affected by shingles. Almost 10-20% of the people diagnosed with shingles are likely to develop ophthalmic shingles. People above the age of 50 are at a greater risk of developing shingles in the eye.

Shingles in the Eye: Symptoms

On getting reactivated, the varicella zoster virus causes infection along the pathways of the sensory nerve on one side of the face or a part of the body. The first sign of shingles is a burning pain and itching sensation around the affected dermatome. This typically occurs two weeks prior to the appearance of a rash or clusters of painful fluid-filled blisters along the pathway. Besides these characteristic signs of shingles, other symptoms include mild fever, fatigue and irritation on the area affected by shingles. The parts of the eyes that could get affected by shingles in the eye include the cornea, iris, retina or the optic nerve. The skin around the eyes may also become tender. Development of a rash on the tip of the nose is a common sign of ophthalmic shingles.

The rashes continue to develop up to a week. After that they begin to crust and may fall off within a couple of weeks. Besides the characteristic rash that is caused by shingles on the eye, other symptoms that may be experienced include pain and itching in the eye, swelling in and around the eye, constant watering, dryness of the eye, increased sensitivity to light or blurred vision. The cornea may become inflamed. If medical treatment is administered on time, the symptoms may resolve within 2-3 weeks. If a delay is made in seeking medical help, shingles in the eye could lead to eye problems such as glaucoma, conjunctivitis, blepharitis, retinitis, ptosis, optic neuritis, postherpetic neuralgia, etc.

Shingles in the Eye: Treatment

If one experiences any of the aforementioned symptoms, one must immediately consult an ophthalmologist. Since shingles is a viral infection, the treatment involves the use of antiviral drugs and anti-inflammatory drugs. Zovirax (acyclovir), Valtrex (valacyclovir) or Famvir (famciclovir) are antiviral drugs that are prescribed for the treatment of shingles in the eye. Besides these drugs, one may also be asked to topically apply medicated creams on the skin rashes. The use of medicated eye drops would also be recommended for alleviating pain and redness in the affected eye. Analgesics may also be prescribed to relieve pain associated with shingles in the eye.

A timely diagnosis and treatment is extremely essential. One must make sure that the drugs are administered within 72 hours from the onset of the symptoms. A timely treatment also lowers the risk of postherpetic neuralgia, which is characterized by pain and sensitivity that is felt along the affected dermatome even after the visible signs of the viral infection disappear. The treatment of postherpetic neuralgia often involves the use of pain medication, anticonvulsants, antidepressants or corticosteroids. Since shingles occurs due to reactivation of the causative agent of chickenpox, getting vaccinated for chickenpox can help in preventing shingles.

Since a person with a weakened immune system is more likely to suffer from outbreaks in future, one must also follow a healthy diet and take steps to strengthen one's immune system. Stress often acts as a trigger which is why one must try to stay relaxed and stress-free. It would be in one's best interest to quit smoking and cut down on one's intake of alcohol. A person infected with this virus can pass on the virus to those who have never been exposed to this virus before. Under such circumstances, the person who gets infected would develop chickenpox. It is therefore advised that a person suffering from shingles should refrain from maintaining physical contact with children or adults who have not had chickenpox.

This was a brief overview of shingles in the eye. Oral antiviral therapy coupled with topical therapy can certainly help in alleviating the symptoms of shingles. Topical application of steroid-antibiotic combination creams and administration of medicated eye drops will also help in preventing secondary bacterial infections and a host of ocular complications. If left untreated, shingles can lead to serious complications that could even lead to blindness. One must therefore never ignore any symptoms associated with shingles in the eye.