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Shingles In The Eye

A Typical Shingles Story 

A patient walked into our office, not quite knowing how to explain her symptoms. “My right eye just doesn’t feel right. It is itchy and red and watery. My left eye seems fine. I went to my primary care doctor yesterday and she gave me some allergy medication but it hasn’t helped. In fact, it has gotten worse today. What could be wrong?” Shingles in the eye! That is what could be wrong.

Most people don’t ever think of their eyes getting this condition. But it is something that we see every day in our eyecare practice. And when it is in the eye, it can be very dangerous and put you at risk for vision loss.

What is Shingles?

Just like you’ve heard again and again on those TV commercials…..It is caused by the varicella zoster virus, the same virus that causes chicken pox. Anyone who had chicken pox is at risk for developing it.

What are the Symptoms?

Often it will start with a ‘feeling’…. a subtle burning, swelling, itching or tingling on only one side of the body. It is hard to diagnose at that point, especially if it is in the eye. Once the rash of fluid filled blister appear, it is easy to confirm the condition. Shingles can be anyplace on the body but the most common area is the torso around the waist, and the second most common is the face and eye. Often we will see the first blister on the tip of the nose.

How is Shingles in the eye different?

Over a million US citizens will get it, and 10 to 20% of them will get it in or around the eye. The skin lesions it causes are very painful, but when you develop shingles in the eye, called herpes zoster ophthalmicus, you are at risk for vision loss.

Unlike most conditions, shingles can affect every part of the eye. We often see corneal abrasions, ulcers, inflammation of the cornea, glaucoma induced by shingles, and even retinal damage in patients with shingles. The good news is that if we see the patient in the early days of the outbreak, we can successfully treat it. Only rarely do we see patient with permanent vision loss.

A Shingles Patient Story

Dr. Scott Han of The Eye Associates recently had patient with shingles in the eye, affecting the cornea. “My patient came in exhibiting loss of vision, dry eyes and pain. It turned out that she had a case of severe shingles in her eye, to the point that the eye had already started to ulcerate and scar. She was in a lot of pain and had even lost some vision. Fearing that the patient could have permanent vision loss, I began a daily regimen of oral and topical medications. After weeks of treatment, her shingles was not totally resolved but at least was under control. Unfortunately, she was left with scar tissue on the cornea and decreased vision. I decided to use a new treatment, an amniotic membrane tissue, in hopes of preventing new scar tissue and reducing the scar tissue that had already formed. It worked. Her vision has returned to normal and she is now out of pain.”

Who gets it?

As we age, our immune system gets weaker and can also be compromised by medications, illnesses, and stress. These things cause an increased risk for developing it. It is estimated that 1 in 3 Americans will get shingles at some point in their lifetime. It is also more prevalent in women.

What can you do about it?

1) Prevention is always the best treatment. We recommend that our patients 60 and older get the vaccine. While the vaccine does not ‘prevent’ shingles, it may lessen the severity of the episode.

2) If you develop it, it is important to seek treatment as soon as possible. At The Eye Associates, we will put a shingle patient in an ‘emergency’ spot so that they can be seen quickly.

3) And of course, you must take all medications as prescribed. It is nothing to mess around with.

Is Shingles Contagious?

Even though shingles can be shocking to look at, it is not contagious. But there have been cases when a child that has never had chickenpox comes into contact with an open lesion, then the child will develop chickenpox; not shingles.

Can Shingles Reoccur?

It doesn’t always reoccur, but unfortunately it can. It is mostly to happen if you have a weak immune system or if you take medications that suppress your immune system. Also, it can even reoccur if you have had the vaccine. There are no guarantees.

If you think you might have shingles in the eye, call us immediately at 1-866-865-2020 for an evaluation with one of our Board Certified eye physicians. The sooner treatment is started, the better the outcome.