What is shingles and how does it affect the eyes?

in Contributors/Dr. Mark Siegel, MD FAAO/Health by

By DR. MARK SEIGLE

Shingles is a painful red rash with blisters that break open and then scab over. It is caused by the herpes zoster virus. This is the same virus that causes chicken pox.

After you have had chicken pox, the virus stays in your body’s nerve cells. It may remain dormant and you will not have any symptoms. But sometimes the virus becomes active again and causes new problems.

Herpes zoster can become active again as you get older, particularly older than age 50. This can be due to your body’s natural aging process. Or it can be due to anything that weakens your immune system, including illness or disease (such as HIV or other diseases of the immune system), fatigue or exhaustion, stress or anxiety, poor nutrition, chemotherapy, radiation therapy and certain medicines that suppress your immune system, such as corticosteroids or cyclosporins.

Avoid spreading 

the shingles virus

Herpes zoster can be contagious. But it can only be passed to others who have not had chicken pox. Someone newly infected with the herpes zoster virus will then develop chicken pox, not shingles.

If you have shingles, avoid being around people who may be more easily infected. This includes infants, pregnant women and people with weakened immune systems.

Shingles starts with pain, itching and tingling of the skin. Redness and numbness leads to a rash. Blisters form, then they break open and scab over. The blisters and scabs can last a few weeks. The pain and tingling can last much longer, though it is rarely permanent.

How does shingles 

affect the eye?

If the herpes zoster virus infects the nerves of the eye, it can cause problems. 

Those problems can include a rash on both your upper and lower eyelids; redness, burning, and oozing on the inside of your eyelids and white part of your eye – this is known as pink eye or conjunctivitis; dry eye; the risk of bacterial eye infections; blurry vision and extra sensitivity to bright light; pain, swelling, and redness inside your eye (called iritis); swelling of the optic nerve behind your eye (called optic neuritis); and a breakdown of the surface of the cornea.

When shingles affects the eye, you are at risk for more severe problems. These include glaucoma, cataracts, double vision and scarring of the cornea.

Treatment will focus on relieving the rash, swelling and pain of shingles. It may include oral medicine called an antiviral – you should take this immediately after you notice symptoms. Antivirals can shorten the length and severity of a shingles rash.

Other treatments include placing cool, moist compresses over your closed eyes for relief; taking certain medicines to help reduce redness, relieve pain, and treat the virus; or using eye drops to fight infection or moisten your eyes.

If shingles has caused glaucoma, cataracts, double vision or eye scarring, other treatments are necessary. Your ophthalmologist will discuss surgery or other types of medicine if they are recommended.

The shingles vaccine

A shingles vaccine called Shingrix is recommended for people 50 years and older. This vaccine lowers the risk of getting painful shingles. 

But the shingles vaccine does not treat active shingles or pain that has developed after the rash is gone. Talk with your doctor about this vaccine and if it is recommended for you.

Dr. Mark S. Siegel is the Medical Director at Sea Island Ophthalmology, LLC. Visit www.seaislandophthalmolo