The onset of a sudden irritating sensation resulting in pain, blister, and often rash on the skin is common to many who come in contact with a virus known as Varicella zoster. Commonly known as shingles, it may affect any part of the body including chest, back, abdominal region, face, nose, forehead, scalp, and even eye.
What is Ocular Shingles?
Shingles when occurring in the eye is known as ocular shingles or ophthalmic herpes zoster. In medical terminology, it is called Herpes Zoster Ophthalmicus (HZO). If untreated, ocular shingles may cause the patient to suffer severely including permanent vision impairment. (1, 2) It attacks either of the eyes at a time and affects any places like the cornea, retina, and lens of the eye. The percentage of people being affected by ocular shingles varies within 10 to 20 percent of the people affected by shingles. (3)
The Source Of The Ocular Shingles Virus
Varicella zoster is the same virus that causes chickenpox in the human body. The virus enters the body either due to any previous medical history of chickenpox or, getting the vaccine of the same. If the traces of the virus stay in the body, it can remain in the dormant state for several years only to surface all of a sudden. Following three conditions increase the chance of infection- (4)
- Coming in contact with Varicella zoster responsible for Chickenpox
- Increasing age enhances the possibility of infection
- Compromised immunity is another reason for such infection.
Symptoms of Ocular Shingles
Ocular shingles have multiple symptoms. As soon as the early signs emerges, one should seek the intervention of a physician and go for pathological diagnosis. The most common symptoms of Ocular Shingles include –
- Tingling or burning sensation on the face or scalp
- Presence of rash or blisters on the nose and forehead
- Inflamed eyelids with mild to severe pain in the eye
- Redness is often accompanied by pain in the eye
- Tears coming from the eyes
- Blurred vision
- Enhanced sensitivity towards light.
Diagnosis of Ocular Shingles
Zoster rash around the eyes including forehead and eyelid is typical of this disease. (1) The case history of a patient with this disease may include –
- Fever, chills and malaise
- Rash with eyelid edema
- Affected dermatome
- Paresthesia or hyperesthesia that may or may not be severe.
- Maculopapular rash that turns vesicular after some days consequently pustular before forming a crust.
Ocular shingles can affect any part of the eye including optic nerves. It can cause keratitis, optic neuritis, scleritis, uveitis, acute retinal necrosis, nerve palsies, trabeculitis, cavernous sinus thrombosis and choroiditis. (4)
What are the Treatments of Ocular Shingles?
The treatment procedure involves both diagnosis of the issue and prescribing medicine for the same: (4)
- Antiviral medicines like acyclovir, famciclovir, and valacyclovir remain as the first line of drugs and may continue for seven to ten days.
- While treating the infection, doctors keep their objectives focused on constricting the virus within the affected zone, healing the blisters, and gradually reducing the rash while relieving the pain.
- Doctors may administer steroids when they need to effectively deal with inflammation since inflammation may severely damage the eye.
- Treatment may include ointment and any such medications while curing throughout a couple of months.
- Treatment may include adequate measures to cure postherpetic neuralgia (PHN) too.
Your doctor can tell you if the disease is complicated and he can recommend you the best for your recovery without pushing your blood vessels carrying more adrenaline. In some cases, the disease is considered a medical emergency. (5)
The symptoms are evident and once noted one should get to seek medical intervention without delay.
Beginning the treatment as soon as possible is the only solution to safeguard your vision and reduce your suffering.
- Womack LW, Liesegang TJ. Complications of herpes zoster ophthalmicus. Arch Ophthalmol. 1983;101:42–5.