Herpes Zoster / Shingles
What Is Herpes Zoster / Shingles?
The virus known as herpes zoster, more commonly known as shingles, can affect the eyes. It is caused when your body’s immunity to the childhood chicken pox virus (the varicalla-zoster virus) breaks down. When you lose your immunity to the virus, it becomes reactivated. The virus then progresses along nerves and settles in a localized area somewhere in the body, causing a rash, itching and pain. The shingles’ rash can also result in small blisters called vesicles, which can rupture and cause scarring. Shingles can also result in numbness and long term pain called neuralgia.
Losing your immunity to the virus can be caused by many factors, including aging and a compromised immunity system. Compromised immunity can be triggered by many factors including an autoimmune disease, illness, stress, fatigue, as well as chemotherapy and certain medications. Sometimes, shingles occurs for no apparent reason. According to the Senior Health Forum, people over the age of 80 are five times more likely to have shingles than people in their 20s to 40s.
Once the virus is reactivated, it is not likely to recur in people with healthy immune systems. However, if you suffer from an autoimmune disorder, shingles can recur.
If the herpes zoster virus settles in nerves in your cheeks, nose or forehead, it may also affect your eyes. This can result in painful blisters on or inside of your eyelids. It’s also possible for shingles to impact your conjunctiva, the membrane that covers the white of your eye, as well as your cornea. In the cornea, the virus can cause corneal abrasions which, if untreated, can lead to infections in your eye and corneal ulcers. The virus can also result in painful inflammation in your eye which is known uveitis or iritis. Because the virus travels along nerves, it can also impact your retina and optic nerve, although this happens less frequently. Any of these conditions, if left untreated, can result in loss of vision.
Acute pain is common at the time of infection, as well as in the neuralgia which remains after the initial symptoms disappear. There is a correlation between increased age and the severity of the pain associated with shingles of the eye.
Symptoms of herpes zoster of the eye may include blisters, redness, pain or burning, itchiness and extreme skin sensitivity. This may also be accompanied by a headache, a fever and a general sense of not feeling well. You should contact your doctor immediately if you experience one or more of these symptoms. Early detection and treatment is necessary to prevent potentially serious vision loss.
Who Is at Risk for Herpes Zoster or Shingles?
Anyone who has had chicken pox is at risk for developing shingles. If you are an adult and have never had chicken pox, you can now be inoculated with Varivax™ to prevent the virus. In addition, if you are over 60 years of age, have already had chicken pox but have not had shingles, a vaccine called Zostavax™ is a available which can prevent or minimize shingles.
The good news is that you can’t “catch” shingles from someone else. However, if you have shingles, it is possible to pass the virus onto someone who has never had chickenpox and has not been vaccinated. This usually occurs only when the other person comes in direct contact with your blisters, before they have formed scabs. If you have a widespread case of herpes zoster, you can, on rare occasions, pass on the virus via skin to skin contact or airborne dissemination of the virus. While shingles is active, you should particularly avoid contact with babies, unvaccinated children and pregnant women.
How Is Herpes Zoster or Shingles Treated?
Once your doctor has diagnosed shingles, he / she will prescribe a course of action based upon your particular circumstances. Most often, an anti-viral medication such as Acyclovir, Valtrex, or Famvir will be prescribed. This medication can help reduce symptoms and prevent complications, especially if you begin taking it immediately after you first experience symptoms. In addition, treatment may include antibiotic and / or steroid drops or ointment. If your intraocular pressure is high, your doctor may also prescribe an anti-glaucoma drop. If you should develop a chronic corneal ulcer, a therapeutic soft contact lens, along with antibiotic drops, may be prescribed.
One complication from ocular shingles can be numbness in your cornea. This means that if you get something in your eye, such as an eyelash or a grain of sand, you won’t be able to feel it. This can lead to on-going conditions such as corneal ulcers. Chronic inflammation can also occur, which can lead to scarring. In severe cases, inflammation and scarring may require corneal transplantation. For this reason, once you have been diagnosed with shingles in the eye, regular and on-going eye examinations will play a critical role in preserving your vision.