Herpes Zoster Ophthalmicus

What is herpes zoster ophthalmicus?

A herpes zoster infection, commonly known as shingles, is a common viral infection. When this involves a nerve in the face called the ophthalmic nerve, the medical term for this kind of shingles is herpes zoster ophthalmicus or ophthalmic shingles. Shingles occurs when the chickenpox virus reactivates in later life. People who have had chickenpox are at risk of developing this condition. It most commonly affects older people and people who have a weakened immune system. The typical symptom of this condition is a painful, blistering rash over the face and eye, and a painful, red eye on the same side as the rash. This is treated with anti-viral medications, which may need to be given through a drip (intravenously) if symptoms are severe. People with shingles should avoid contact with people who have not been vaccinated against chickenpox and people who have a weakened immune system. This condition can cause permanent vision problems if not treated quickly.

Risks

Herpes zoster is caused by an infection with the varicella-zoster virus (VZV). This virus causes two different conditions. The first, chickenpox, is a widespread, blistering rash. The virus then stays quiet in the body for a number of years before recurring as shingles. Although having chickenpox usually makes one immune to having chickenpox again, it does not make one immune to shingles. Ophthalmic shingles are shingles which occur in a particular area of the face. This happens because the nerve in the area, the ophthalmic nerve, has been affected. Shingles tends to affect older people, and people who have a weakened immune system. People who had chicken pox as a child are at risk of developing this condition.

Symptoms

Ophthalmic shingles often begins with a tingling, burning pain over the eye, forehead, temple and nose. This is followed by a blistering rash. The area may also feel numb. People with this condition develop a painful, watering eye on the same side as the rash, along with swelling around the eye and, sometimes, vision problems. People with shingles may also have a headache, fever, lose their appetite and feel generally unwell.

Diagnosis

The diagnosis can usually be confidently made based on the symptoms and the appearance of the rash. If uncertain, the diagnosis can be confirmed with blood tests or by taking a sample of fluid from a blister and testing for the virus.

Treatment

Ophthalmic shingles should be treated urgently with anti-viral medication. People who have a weakened immune system or who develop severe sight problems may need to receive this anti-viral medication through a drip (intravenously). Steroid-containing eye drops may also be needed. Anti-inflammatory medications, such as ibuprofen, may help reduce the pain and swelling. People with shingles should try to avoid scratching at the rash.

Prevention

People who have shingles should keep away from people who have not been vaccinated against chickenpox (especially newborns) and people who have a weak immune system. Vaccination against chickenpox (the varicella vaccination) and herpes zoster (a herpes zoster vaccination) can help to prevent and reduce the severity of some cases of shingles.

Other names for herpes zoster ophthalmicus

  • Shingles affecting the eye
  • Herpes Zoster Ophthalmicus
  • Zoster Ophthalmicus
  • Ophthalmic shingles