Ophthalmic Shingles (Herpes Zoster Ophthalmicus)

Shingles occurs in patients who have previously had chickpox. It is caused by the herpes zoster virus, which can reside in the nerves for many years. When this reactivates, it leads to shingles in area served by that nerve. When the ophthalmic nerve is affected, it is termed ophthalmic shingles or herpes zoster ophthalmicus. The condition typically affects those above the age of 50 years or those with a weakened immune system.

Ophthalmic Shingles (Herpes Zoster Ophthalmicus)

Shingles occurs in patients who have previously had chickpox. It is caused by the herpes zoster virus, which can reside in the nerves for many years. When this reactivates, it leads to shingles in area served by that nerve. When the ophthalmic nerve is affected, it is termed ophthalmic shingles or herpes zoster ophthalmicus. The condition typically affects those above the age of 50 years or those with a weakened immune system.

What are the symptoms of ophthalmic shingles?

The first symptom of ophthalmic shingles is a rash affecting one side of the forehead, scalp and upper eyelid. The rash may also affect the nose. The rash typically starts with pain and tenderness, before showing blisters that then crust over and resolve within 3-6 weeks. In half of patients, the eyeball may be affected and can become red, swollen, sensitive to light and the vision may become blurred.

FREQUENTLY ASKED QUESTIONS

Ophthalmic shingles should be treated with antiviral tablets for 7-10 days. The treatment works best if it is started within 72 hours of the rash appearing. The treatment helps reduce the severity of the disease and complications of the condition.

Shingles is caused by the herpes zoster virus, which also causes chickpox. Shingles is contagious whilst the rash is in the wet blistering phase. Others who have had chickenpox previously are immune to infection. Those who have received the shingles vaccine are also immune to new infection. Newborns and those with a weakened immune system are at highest risk.

Ophthalmic shingles can affect the eye in about half of patients. The most common complication is conjunctivitis, where the eye becomes red and swollen. The cornea may also be affected by ulceration and inflammation. The eye pressure my become raised, and inflammatory eye disease (uveitis) may also occur. The most serious complications of ophthalmic shingles are inflammation of the retina (acute retinal necrosis) and optic nerve. Many of these conditions require urgent treatment to prevent sight loss.