Herpes zoster ophthalmicus, or ocular shingles, develops after reactivation of the chickenpox virus which can occur years after the original infection. Involvement of the face and eye is common and can lead to significant eye complications depending on the level and amount of involvement. These complications can be sight threatening.
Eyelid Changes
Ocular shingles can cause a painful rash with little blisters that burst and ooze on the face and upper eyelid. The fluid from the ruptured blisters can dry and form crusts, which are part of the typical presentation of ocular shingles. According to the American Uveitis Society, this rash can lead to scarring and a loss of eyelashes.
Conjunctiva Symptoms
The conjunctiva becomes red and swollen in ocular shingles. According to a 2002 article in the journal American Family Physician by Saad Shaikh, M.D., and Christopher N. Ta, M.D., these symptoms usually resolve in one week. However, sometimes the conjunctiva can become secondarily infected, which requires topical or systemic antibiotic treatment.
Episcleritis/Scleritis
Ocular shingles may also involve the white part of the eye, the sclera, or the thin covering over the sclera, the episcleritis. According to Shaikh and Ta, both episcleritis and scleritis can involve pain, swelling and redness, but episcleritis is not as serious a condition as scleritis.
Corneal Involvement
Ocular shingles can affect different parts of the cornea. The epithelium, or outer layer of the cornea, can be infected; according to the All About Vision website. This type of infection usually heals without scarring. However, the middle layer of the cornea--called the stroma--can be affected in ocular shingles as well. The inflammation caused by the disease can scar the stroma, leading to loss of vision or blindness.
Uveitis
Another symptom of ocular shingles is uveitis. In uveitis, the iris becomes inflamed, which causes pain, blurred vision and light-sensitivity, according to the All About Vision website. If the inflammation inside the eye is not managed properly, the inflammatory materials that are produced can interfere with the drainage channels inside the eye, which can lead to glaucoma.
Retinitis
The retina in the back of the eye can develop the herpes infection as well, according to the American Uveitis Society website. This can cause inflammation in the retina, and the damage can spread throughout the retina and can significantly compromise vision, according to Shaikh and Ta.
References
- "American Family Physician"; Evaluation and Management of Herpes Zoster Ophthalmicus; Saad Shaikh, M.D., and Christopher N. Ta, M.D.; 2002.
- All About Vision: Eye Herpes (Ocular Herpes)
- Uninversity of Michigan Kellogg Eye Center: Herpes Zoster (Shingles)
- American Uveitis Society: Herpes Zoster Ophthalmicus
