- Shingles in the eye, aka herpes zoster ophthalmicus, occurs in about 10% to 20% of all shingles cases.
- It can result in complications like damage to the cornea and blindness, so it’s important to see your doctor right away.
- You can prevent shingles in the eye by getting the Shingrix vaccine.
- This article was medically reviewed by Benjamin Bert, MD, an ophthalmologist at MemorialCare Orange Coast Medical Centre in Fountain Valley, California.
- Visit Insider’s Health Reference library for more advice.
Shingles is a painful rash caused by a reactivation of the varicella-zoster virus, the same virus that causes chickenpox. It’s a very common condition, as one out of three people will develop it throughout their lifetime, most often after the age of 50. Although the shingles rash will most commonly appear on the torso, it’s possible for it to affect your eyes as well.
Shingles of the eye has its own name: herpes zoster ophthalmicus (HZO). Recent research by the University of Michigan Kellogg Eye Centre found that the incidence of HZO tripled between 2004 and 2016. They also determined HZO is most common in those over 75 years old.
Here’s what you need to know about symptoms of shingles in the eye, as well as complications and treatment.
Symptoms of shingles in the eye
Shingles typically affects only one side of the body. This is because the varicella-zoster virus lays dormant in your body in nerve cells after you have chickenpox. When the virus is reactivated, it affects a nerve that it travels down, so the shingles rash will appear on the side of the affected nerve. So if you get it on your face, it will only affect either the right or left side.
Shingles on your face will not always affect your eyes, but there’s certainly a possibility that it can. About 10-20% of shingles cases will appear on or around the eye. If you have shingles of the eye, Randall McLaughlin, OD, associate professor of ophthalmology at The Ohio State University College of Medicine, says a painful rash and blisters may appear on:
- The forehead
- The eyelid
- The tip of your nose
You should be particularly concerned if the rash is on the tip of the nose, as McLaughlin says this is typically the telltale sign that the eye is being affected. Additionally, you may notice changes to your normal vision, such as experiencing blurred vision.
According to the American Academy of Ophthalmology, you may also experience other shingles symptoms that can appear even before the rash surfaces such as:
- Feeling generally unwell
- Burning sensations
- Tingling sensations
- Sensitivity to light
If you suspect you have singles in your eye, you should see your doctor as soon as you can to prevent possible permanent damage.
Complications of shingles in the eye
Although it’s possible to have complications from a regular shingles infection, your vision is at stake if your eye is involved. Dangerous complications of shingles of the eye may include:
- Eye damage such as scarring of the cornea, says McLaughlin
- Blindness in severe cases
When you have shingles of the eye, the nerves of the cornea become inflamed, and as this heals, it can lead to scarring, says McLaughlin. This can result in decreased vision sharpness, and cannot be corrected with glasses. In some cases, a corneal transplant may be necessary. Blindness, a full loss of vision, is more of a rare complication. This is why it’s so important to start treatment early to avoid these possible permanent problems.
McLaughlin says complications vary on an individualized basis, and not everybody will experience them. The sooner you seek medical attention and start treatment, the less likely you will be to have complications.
A complication that can arise from any shingles infection is postherpetic neuralgia, which can leave you with long-lasting pain, numbness, and itching that remains three months or longer after the infection goes away. Again, starting treatment early will reduce your risk of this complication as well.
The best treatment is defence so that the shingles infection never happens in the first place. McLaughlin says the shingles vaccine can significantly reduce your risk of getting shingles. He strongly recommends it for people over 50 years old. According to the CDC, the Shingrix vaccine is 97% effective in preventing shingles in people aged 50 to 69, and 91% effective in people 70 and older.
You only need two doses of the Shingrix vaccine, and then you’ll be all set. The CDC recommends it for people over 50 even if they have had shingles before, if they have had the older (and less effective) shingles vaccine, Zostavax, or if they aren’t sure if they had chickenpox when they were younger or not.
The vaccine has been determined to be safe. Mild side effects such as pain at injection site, headaches, and fatigue may occur for two to three days.
Treatment of shingles in the eye
However, if you do end up with shingles, McLaughlin says the most effective treatment is antiviral medication.
The sooner you can start it, the better. Antiviral medications are most effective when started within 72 hours. These meds will reduce the duration and severity of your infection, as well as lower your risk of having those complications of eye damage, blindness, and postherpetic neuralgia.
Common antiviral medications prescribed for shingles are:
Additionally, for shingles of the eye specifically, McLaughlin says that steroid eye drops may be prescribed to combat inflammation of the cornea. Regardless of the treatment plan, you will need to be closely monitored by your eye doctor to ensure that you’re on the right track to feeling better and that you will heal from the infection without lasting complications.
Related articles from Health Reference:
- You can get shingles more than once – here’s who’s most at risk
- If you’ve had chickenpox you’re at risk of a painful condition called shingles – here’s why
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