Herpes zoster, sometimes referred to as shingles, is a common infection due to the herpes virus. It is a blistering and painful rash, that sometimes has long-term side-effects. There is no absolute cure for herpes zoster, but early detection and treatment can lessen you risk for more serious complications. In 10 to 20 percent of people with herpes zoster, the rash will appear around the eye. Without treatment, patients run the risk of scarring, vision loss and other long-term issues.
What causes herpes zoster?
Once you have chickenpox, the virus remains dormant in the nerve cells of the spine for years. It is triggered and reactivated, migrating down sensory nerves to the skin to cause herpes zoster.
Triggering factors are sometimes recognized, such as:
- Pressure on the nerve roots
- Radiotherapy at the level of the affected nerve root
- Spinal surgery
- An infection
- An injury (not necessarily to the spine)
- Contact with someone with varicella or herpes zoster
What are the symptoms?
The first sign of the infection is usually pain, which may be severe. The pain may be just in one spot or it may spread out. A fever and headache may add to the patient’s discomfort. In one to three days a blistering rash will form on your eyelids, forehead and possibly on the tip of your nose. New lesions can continue to appear for several days, each one blistering or becoming pustular then crusting over. You may also experience swelling in parts of your eyelid, retina and cornea.
Who’s at Risk?
Anyone that has previously had chickenpox (varicella) may subsequently develop zoster. It is more common in adults, especially the elderly, but children have been known to contract the malady. People who have had zoster rarely get it again; the risk of getting a second episode is about 1%. Herpes zoster often affects people with poor immunity. If you are over age 50, you can get vaccinated and be protected from contracting it.
How is it diagnosed?
Doctors use two types of tests to diagnose chickenpox or shingles.
When you’re exposed to varicella zoster, your immune system makes proteins to fight it. Your doctor can look for these proteins, called antibodies, in a sample of your blood. He takes the sample from a vein in your arm. These tests might be able to tell whether you have chickenpox now or have had it in the past, but the results are often hard to interpret.
Viral detection: This test can find out if varicella zoster is inside a sample of your cells. To collect the sample, your doctor can:
- Scrape off cells and fluid from a blister
- Pull fluid from your spine with a needle
Your doctor should have the results in 1 to 3 days. You might need to have a second test if the results aren’t clear.
How is it treated?
Antiviral treatment can reduce pain and the duration of symptoms if started within one to three days after the onset of herpes zoster. These medicines may stop the virus from spreading, help the blisters heal, help the rash fade more quickly and relieve pain and discomfort.
The rash should heal within 7 to 21 days. Elimination of symptoms completely, may take a few months.
If you are experiencing any of the symptoms mentioned above, contact MidWest Eye Center immediately to be seen by one of our doctors or schedule an appointment with one of our Retina Specialists at (800) 385-EYES (3937).
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Doctors Who Treat This Condition
Saif Jaweed, M.D.
Jean Noll, M.D.
Katie Holnbeck, O.D.
Philip G. Kies, O.D.
Erin Mosellen, O.D., F.A.A.O.