Ocular Shingles

Chicken pox is caused by the herpes zoster virus. The same herpes zoster virus can recur decades later causing shingles, most commonly on the trunk of the body. When it occurs around the eye, it is called herpes zoster ophthalmicus. It often begins with a tingling or burning sensation of the scalp, forehead or cheeks. A few days later it may break out into a painful rash. If caught within the first few days of the rash, shingles is treated with antiviral pills. It can also affect the cornea and cause inflammation in the front or back of the eye and also glaucoma. Depending on the exact ocular involvement, shingles in the eye may be treated with a variety of medications, including steroids. As in the treatment of herpes simplex keratitis, if steroids are used, they often need to be decreased very slowly, frequently over months or years. Shingles may also cause chronic skin sensitivity or pain, termed postherpetic neuralgia (PHN). PHN often subsides over months, but if not, certain medications can be helpful.