Herpes Zoster is the medical term for the reactivation of the virus that causes the common childhood disease, “chicken pox”.   The virus lies dormant in the nerve cells after the bout of chicken pox resolves.  The reactivation may occur as a response to fatigue, stress, an impaired immune system, certain medications or for no apparent reason.  It strikes all age groups but usually occurs in older people.

Herpes Zoster manifests itself as a skin rash and blisters (shingles).  It is often preceded by pain and tingling in the same area.  These blisters occur on only one side of the body.  This eruption may occur anywhere but the most concerning area is the upper part of the face and eyelids.  The eye itself can become infected with serious consequences.  Manifestations of the infection vary from a small cluster of blisters to severely painful and swollen rash.  A patient may experience a fever and malaise.  A person may contract chicken pox from an individual with Zoster but the reverse is not true.

Specific eye problems vary.  The lids are most commonly affected.  Conjunctivitis is very common.  The cornea may have lesions on the surface causing a condition known as keratitis.  The anterior portion inside the eye may become inflamed causing a condition known as iritis.  Both keratitis and iritis need close medical attention in order to prevent permanent issues.  Glaucoma, cataracts and a burning sensation of the affected skin may occur.  Rarely the retinal tissue in the back of the eye may be involved.

Treatment consists of oral antivirals and sometimes oral steroids or antibiotics.  Topical antiviral eye drops with or without topical steroids may also be prescribed.  Hospitalization may be necessary in severe cases.  If the intraocular pressure is elevated, eye drops used for glaucoma are administered to prevent damage to the optic nerve.

Scarring of the cornea and inside the eye is the ultimate concern for patients with Herpes Zoster involving the eye.  Lingering pain in the area of the previous skin rash may occur and can be difficult to control.  The patient needs to be aware that recurrences are possible.  Should a patient experience symptoms similar to those experienced with the initial episode, an eye doctor should be consulted immediately.  In conclusion, Herpes Zoster is a reactivation of the virus which causes “chicken pox”.  When this infection occurs around the eye, serious problems may develop.  With early detection and careful management, the chance of a severe eye problem caused by Herpes Zoster can be drastically reduced.