Shingles or herpes zoster is caused by varicella zoster virus. It is a member of human herpes virus family. Chickenpox is a primary infection which is usually a childhood disease, but it can also occur in an adult individual. Once chickenpox heals, the virus lies dormant in the nerve roots of the spine. It may get reactivated again some other time. It appears in the form of shingles.
Basically shingles is a nerve infection. When the virus gets reactivated it travels to the affected nerve (spinal and cranial nerve) resulting in unilateral radicular pain, burning and water filled tiny eruptions.If the virus affects the nerve that innervates the eye, it may lead to shingles of eye. There is a chance of permanent vision loss if the patient does not recognize and seek early treatment of ophthalmic shingles.
Causes Of Shingles In The Eye
Shingles in general and particularly in the eye occurs sporadically throughout the year. It can occur at all ages, but maximum incidences are seen in fourth, fifth and sixth decades of life. It is usually the disease of adults and is uncommon in childhood. Most often the reactivation of herpes virus occurs when the immune system becomes low.
Excessive stress level is also responsible for provocating the dormant virus to become active. It then travels to the affected nerve root. Shingles in the eye occurs when the ophthalmic branch of fifth nerve which is called trigeminal nerve is involved. This may result in burning, pain on the forehead, eye, nose, and cheek. If the branch of trigeminal nerve that extends to the eye is involved, it can lead to ophthalmic shingles.
Symptoms Of Shingles In The Eye
In the beginning patient may experience pain or tingling sensation on scalp, forehead, and on the face. Generally a rash may appear on the face, which is a particularly fluid filled eruption. However, in the beginning it is difficult to diagnose shingles only if there is pain.
- The eye becomes red.
- It becomes swollen.
- There is extreme pain in the eyes.
- Vision becomes blurry.
- If the virus affects the cornea, an ulcer can form which may permanently blur the vision.
- In some cases pressure inside the eyeball can rise leading to glaucoma.
- There is excessive discharge of tears.
Treatment For Shingles In The Eye
- Treatment of ocular shingles is very important as it may cause loss of vision if prompt care is not taken. Shingles in eye is treated with antiviral medication such as Acyclovir, or Famciclovir. These drugs can be taken orally or in severe cases they are given intravenously.
- Swelling and watering of eyes requires cool compresses. Doctor may also give over the counter medication to relieve pain and swelling. Even topical eye drops are used to reduce the pain and inflammation.
- If started early antiviral medicines will be able to suppress the inflammation faster and shorten the course of disease.
- To prevent shingles from causing vision loss, it is important to start the treatment as early as possible, especially if there is rash on nose, face, near the surrounding of eye. You have to take the treatment early to prevent spread of shingles in the eyes.
- Antiviral are more effective when they are taken 72 hours after the onset of rash.