What is Herpes Zoster?

Herpes zoster, commonly know as “shingles” is a viral disease that causes a characteristic skin rash of small fluid-filled blisters (vesicles) which form scabs and can leave permanent scars.

The first symptom is often severe pain or itching followed by redness of the skin, and finally, the appearance of a few or many of the characteristic blister.  The blisters follow the route of the infected nerve.

Pain is often severe, accompanied by burning, throbbing and extreme skin sensitivity.  The rash lasts three to six weeks but some people experience pain months or years later.  This extended pain is called “post-herpetic neuralgia.”

What Causes herpes Zoster?

Varicella zoster, the same virus that causes chicken pox is responsible for herpes zoster.  After years of dormancy, the virus reactivates, usually attacking older people or those with reduced immunity.

How Does Herpes Zoster Affect the Eye?

Herpes zoster commonly attacks the nerves around the eye, especially the nerve that supplies the upper eyelid and forehead.   If the virus affects the nerves that go directly to the eyeball, it can cause serious eye problems, including corneal ulcers, inflammation and glaucoma.  These problems may appear at the same time as the skin rash or weeks after the vesicles have disappeared.   Lingering pain is the result of injured sensory nerves, which may remain overly sensitive for years after the attack.

What is the Treatment for Herpes Zoster?

The usual procedure is to control pain and prevent further skin infection with soaks, scrubs and other treatments.  Antiviral drugs, steroids, and other medications taken by mouth may be helpful in some circumstances.  If the eyeball is affected, eye drops, eye ointments or oral medications may be necessary.

Most people recover without complications.  Unfortunately, despite all available medicines, some people have permanent visual damage and continue to have pain even after the skin rash has gone away.