Herpes Zoster (Shingles) Eye Infections

What is Herpes Zoster?
Herpes zoster is the medical name for shingles. It is caused by reactivation in the adult years of the chicken pox virus that occurred during childhood (the varicalla-zoster virus). The virus can be reactivated when the body's immunity to the virus breaks down. This may happen due to normal aging, or the body's immune system may become weakened due to stress from illness, physical or emotional stress, fatigue, poor nutrition, certain medications, chemotherapy, radiation therapy, or other factors.

Once reactivated, the virus travels along nerve fibers, usually settling in fairly isolated areas of skin on one side of the body. The infected area of the body usually has severe pain, itching, redness, numbness, and the development of a rash. The rash on the skin develops into small, fluid-filled blisters called vesicles. Within a few days of their appearance on the skin, the vesicles break open and form scabs. In severe cases, the rash can leave permanent scars, long standing pain, numbness, and skin discoloration.

How Does Herpes Zoster Affect The Eyes?
The eyes are sometimes affected by herpes zoster. This is due to the fact that the eyes are connected to nerves that may be infected with the herpes zoster virus.

The usual shingles rash can spread from an involved area of the forehead or cheek to the upper or lower eyelids. Shingles may cause redness of the conjunctiva (the mucous membrane covering the white of the eye). It can also cause small scratches or scarring of the cornea. The scratches on the cornea may increase the risk of bacterial infection in the eye. Shingles may also cause inflammation inside the eye, known as iritis or uveitis. It can also affect the optic nerve or the retina.

Herpes zoster infections of the eye can lead to redness, swelling, pain, sensitivity to light, and blurred vision. Severe or repeated episodes of herpes zoster infection are associated with other eye conditions, including glaucoma, scarring inside the eye, and cataract formation.

Are Herpes Zoster Infections Contagious?
Shingles caused by herpes zoster is not contagious and should not be confused with herpes simplex virus (HSV) infections. At the time the herpes zoster or varicella zoster virus first infects the body causing chickenpox, the infection is contagious. The outbreak of shingles later in life is not a new infection, but rather a reactivation of the dormant virus. For this reason, shingles is not contagious.

How Are Herpes Zoster Eye Infections Treated?
Treatment of the symptoms of shingles through compresses and pain relievers is usually recommended by doctors. Lubricating eyedrops or antibiotic eye drops may aso be prescribed.

The use of antiviral medications may be recommended by your doctor. The medication most commonly prescribed is acyclovir. Occasionally, steroids may be prescribed to reduce inflammation.

By its very nature, herpes zoster infections are prone to return from time to time, especially when the immune system is weakened. Early diagnosis and treatment is important to minimize the symptoms and reduce the risk of complications that may compromise vision.