That painful, itchy sensation near your eye has suddenly turned into a rash. Or, your maybe you suddenly have small blisters on your eyelid, or swelling and redness around the eye. Maybe you also suddenly are experiencing extra sensitivity to the light. While these may be signs of a number of conditions, one possible explanation is shingles, or herpes zoster ophthalmicus.


    Shingles of the eye, herpes zoster ophthalmicus (HZO), is caused by the chickenpox virus, and primarily involves the skin and tissue around the eye without actually affecting the eye itself. However, estimates range vary on how often the eye is affected with some saying as few as 10% of cases involving the actual eye and others citing up to a fourth of patients having eye involvement. Regardless, it is extremely important to seek treatment right away as not treating HZO may lead to complications including loss of vision. Currently there is no ideal preventative for HZO, although it occurs more frequently in the elderly, and typically in those who have either had chickenpox in the past or have been exposed to the chickenpox virus. HZO is also an equal opportunity virus, affecting equal numbers of men and women.


    There are several tell-tale symptoms which point directly to shingles as a diagnosis; however, some symptoms are shared with other eye diseases. Ignoring your symptoms, and not seeking treatment can have detrimental results for your eyes, including development of glaucoma, scarring, or blindness. Shingles of the eye also puts you at higher risk for having a stroke. If you have any of these symptoms, schedule an appointment with your Silverstein Eye Centers specialist right away:

    • Blisters on the eyelid or skin surrounding the eye, including the bridge of the nose
    • Swelling and redness of the eye or eyelid
    • Eye pain or pain around the eye, itching, numbness, or tingling
    • Photophobia – sensitivity to light
    • Blurred vision or sensations of material in the eye
    • Blisters on the tip or bridge of the nose


    Diagnosis of HZO is fairly straightforward and quick, usually involving a simple visual inspection of the eye by your ophthalmologist. Typically, patients have developed a rash or have other obvious symptoms, and your doctor will know just by looking at your eye and surrounding skin if your rash is from shingles or if it has some other cause. The rash from singles has a distinct appearance, and most patients not require additional testing for diagnosis.

    It is important to seek diagnosis and treatment as soon as you have symptoms. Patients who receive treatment within 72 hours of noticing their symptoms are far more likely to have positive results with treatment, and they usually have symptoms for a shorter duration than those who wait to seek help. However, even with immediate treatment, symptoms may last anywhere from weeks to years depending on other factors such as pre-existing health problems, age, and stress.

    Treatments once you have been diagnosed typically include:

    • Anti-viral medications (particularly in the first 72 hours of developing a rash)
    • pain medications
    • Cool compresses to the affected area
    • Nerve blocks
    • Corticosteroids (although not preferred as they can cause the rash to spread)

    After the rash has resolved, treatment may continue with:

    • Anesthetic creams or patches
    • Pain medications
    • Certain anti-seizure or anti-depressants that have proven helpful in shingles management


    Shingles is contagious. You should take care to avoid people who have not had chickenpox, pregnant women, or those who are immune-compromised or sick, particularly those with cancer, HIV, or AIDS. You should also avoid being around any children who have either not had chickenpox or have not been vaccinated against chickenpox.

    If you or someone you love has any of the above symptoms or problems, call Silverstein Eye Centers immediately at 816-358-3600 for evaluation.

    Posted March 20, 2014 by Silverstein Eye Centers
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