Shingles is a viral illness caused by the varicella-zoster virus. Chickenpox develops when a person contracts the varicella-zoster virus. After recovering from chickenpox, the virus remains in the sensory nerves in an inactive state. The varicella-zoster virus can reactivate years after the initial infection, causing shingles. The likelihood for the development of shingles, also known as herpes zoster, increases with advancing age. The National Institute of Neurological Disorders and Stroke reports that approximately one in every four adults develops shingles.
Tingling, Burning, Pain and Itching
The face is the second most common body site for shingles after the trunk, according to the National Institute of Neurological Disorders and Stroke. An episode of shingles typically begins with pain, tingling, burning, itching or a combination of these sensations on one side of the face. The skin around the eye or the eye itself may be involved in some patients. Pain sensations range from mild to severe.
Blistering Rash
After approximately two to three days of abnormal sensations, a red skin rash develops in the affected area of the face, notes the medical reference text "Principles and Practice of Infectious Diseases." Small bumps develop into painful blisters, which may itch. New blisters continue to develop for approximately three to five days. The blisters may merge to form larger lesions. The number of blisters varies from person to person, lasting for approximately two to three weeks, according to the American Academy of Dermatology. The blisters transition from clear to pus-filled before crusting and healing. Scarring may occur in some patients.
Eye Pain, Swelling and Redness
Eye involvement with shingles typically causes redness and swelling of the eyelid with blister development. Redness also develops inside the eyelids and in the white area of the eye. Shingles eyelid blisters typically resolve along with blisters on other areas of the face. Severe pain occurs in the affected eye along with light sensitivity, reports FamilyDoctor.org. Patients with shingles eye involvement require treatment with antiviral medication.
Persistent Facial and Eye Pain
Approximately 25 to 50 percent of people who develop shingles after age 50 have persistent pain after the skin lesions resolve, according to "Principles and Practice of Infectious Diseases." This condition, known as postherpetic neuralgia, can cause mild to severe facial and eye pain, which may prove incapacitating. Patients experience constant pain or intermittent stabbing pain. Postherpetic neuralgia may continue for months to years, reports Penn State College of Medicine's Milton S. Hershey Medical Center.
Visual Disturbances
People with facial shingles involving the eye may develop inflammation of the clear cornea at the front of the eye and the internal eye structures, reports the National Eye Institute. Inflammation of the cornea and internal eye structures may occur concurrently with the skin lesions or develop after the blisters resolve. This condition, known as herpes zoster ophthalmicus, often causes visual disturbances, such as blurred or clouded vision. Ongoing treatment with an eye specialist can help reduce the risk of permanent vision loss associated with herpes zoster ophthalmicus.
References
- National Institute of Neurological Disorders and Stroke: Shingles
- "Principles and Practice of Infectious Diseases, Sixth Edition"; Gerald L. Mandell, M.D., et al., Editors; 2004
- American Academy of Dermatology: Herpes Zoster
- Family Doctor: Herpes Zoster Ophthalmicus (HZO)
- Penn State Milton S. Hershey Medical Center: Shingles
