Herpes zoster, or shingles, can occur in any person who ever had chicken pox. Shingles is the reactivation of the same herpes virus at a later date; it presents as a skin rash consisting of blisters. This rash can occur on any part of the body, including around the eye. When the eye is involved, the condition is called herpes zoster ophthalmicus, or ocular shingles. Several different areas of the eye can be affected.
Eyelid Rash
In ocular shingles, a red, crusting rash with small blisters can appear on the upper and lower eyelids. Typically a few days before the rash appears, the patient notices pain, tingling and numbness in the future area of the rash. After healing, this rash can leave scarring of the eyelid or cause a loss of eyelashes.
Inflammation Inside the Eye
According to the American Uveitis Society, inflammation inside the eye, or uveitis, occurs in about 40 percent of patients with ocular shingles. The initial signs are pain, light sensitivity and decreased vision; the eye may also develop elevated pressure or glaucoma because of the inflammation in the eye. The shape of the pupil may also change because of scarring from the inflammation. Cataracts are also a long-term complication of uveitis.
Corneal Problems
The cornea may develop an infection also called an ulcer during an episode of eye shingles; this can lead to corneal scarring after the infection has healed. In ocular shingles, the cornea can also become numb, which makes it easier to injure, and the patient may develop dry eye syndromes. To protect the cornea, the eye doctor may have to stitch the eyelids together temporarily to help keep the eye moist and to keep the cornea from getting scratched. Years after the initial eye shingle episode, the cornea may become cloudy as a result of some of these changes; clear vision may be lost.
Optic Neuritis
An inflammation of the optic nerve called optic neuritis may also be a complication of ocular shingles. This presents with a loss of vision and pain in one eye. This condition tends to improve on its own, and the vision typically returns to normal. Sometimes the eye doctor will start the patient on corticosteroid medications to treat the optic neuritis.
