Shingles in the Eye: Symptoms, Complications, and More

What are Shingles in the Eye?

Shingles in the eye are defined as a viral infection that can cause swelling of the eye and rashes around the eye, body, sides of the face, nose and forehead. Shingles may appear as red or pink blotches and may be caused by the varicella zoster virus according to Health Direct. Shingles may initially feel like a burning or tingling sensation around the body as the first most noticeable symptom. Other common early signs of shingles can include a low fever, flu-like symptoms, headache and a fever.

What is the Other Term for Shingles in the Eye?

The other term for shingles in the eye is herpes zoster ophthalmicus or ophthalmic zoster according to the National Institute of Health.

What Causes Shingles in the Eye?

The causes of shingles or herpes zoster in the eye can be due to the preexisting latent varicella-zoster virus in people who previously experienced chicken pox according to the National Library of Medicine. However, it is important to note that not every person with the inactive virus will develop shingles. The reactivation of the virus can occur as a result of the body’s declining cellular ability to decimate infected cells, which can take place due to increased age and other factors.

Does Wearing Contact Lenses Cause the Shingles in the Eye?

No, wearing contact lenses may not cause shingles in the eye as herpes zoster ophthalmicus develops from the virus that is present in people who have previously contracted chicken pox and other circumstantial factors. Proper daily care of your contact lenses can help prevent the development of any eye infections.

Are Age and Gender a Factor that May Cause Shingles in the Eye?

Yes, age and gender may be factors that cause shingles in the eye due to the body’s declining ability to protect itself against infections. Shingles were found to be present in those aged 65 years and older according to a 2012 analysis of 134 herpes zoster ophthalmicus cases within the Kaiser Permanente Hawaii health plan. The incidence rate of shingles in the eye between men and women exhibited that it occurred more in men than in women. However, it occurred more in women who were older according to a 2021 study in the National Library of Medicine.

What Part of the Eye Does Shingles in the Eye Occur?

Shingles in the eye may occur in the eyelid and surrounding areas. Shingles may occur in front of the eye leading to keratitis which is a common complication of shingles according to Harvard Health Publishing. In rare cases, shingles may also develop in the back of the eye in relation to the optic nerve and the retina. However, this type of shingles in the eye is referred to as viral retinitis and does not manifest as a skin rash but instead may cause inflammation and an infection in the retina. Other regions where shingles in the eye can occur include the forehead, scalp and nose.

The affected eye shows symptoms of redness in the sclera due to shingles in the eye.

What are the Risk Factors of Shingles in the Eye?

The risk factors of shingles in the eye can include advanced age, previously contracted chicken pox and a poor immune system. The risk factors of shingles in the eye are listed below.

Advanced Age: Advanced age may be a risk factor for shingles in the eye as the immune system’s cellular response to infections grows weaker with increased age.
Previously Contracted Chicken Pox: Previously having chicken pox can lead to the development of shingles in the eye due to the varicella-zoster virus going dormant and remaining in the nerve tissues.
Poor Immune System: A poor immune system can contribute as a risk factor for shingles in the eye as the dormant virus can reactivate.

What are the Early Signs That Someone Might be Developing Shingles in the Eye?

The early signs that someone might be developing shingles in the eye are burning, tingling and pain, sensitivity to touch, fever, and a red rash. These early stages of shingles in the eye are the most common. If you experience any of these symptoms, it is important to seek medical attention right away. Other early signs of how to tell if you have shingles in your eye can include aching muscles, tiredness, headaches, nausea and general unwellness according to Healthline. The early signs that someone might be developing shingles in the eye are listed below.

Burning, Tingling and Pain: Burning, tingling and pain may commonly occur in the region where the rash may likely develop. This can take place 1-2 days before the rash develops and has often been characterized by an electrical sensation or feeling, according to the American Academy of Dermatology Association.
Sensitivity to Touch: Sensitivity to touch can be described as the occurrence of pain, sharpness or stinging when touched. This may occur during the early stages of shingles in the eye before the rash appears.
Fever: A fever might occur in the early stages of developing shingles in the eye due to the herpes zoster virus reactivating in the body. A fever is how the body responds in an attempt to fight off the infection.
Red Rash: A red rash can start to develop soon after the burning, tingling and painful sensations occur. The rash can then progress into a rash of painful blisters and scabbing.

What are the Signs and Symptoms of Shingles in the Eye?

The signs and symptoms of shingles in the eye can include blurry vision, eye redness, irritation or tearing, skin redness or rash around the eye. It can also include blisters around the upper eyelid and forehead on one side, burning, throbbing, or itching around the eye and extreme skin sensitivity. The signs and symptoms of shingles in the eye are listed below.

Blurry Vision: Blurry vision can occur as a symptom of shingles in the eye as it may also implicate some nerves of the head, which can cause the infection to spread to the eyelid, the surface of the eye and inner structures of the eye according to Harvard Health Publishing.
Eye Redness, Irritation or Tearing: Eye redness, irritation or tearing may develop as symptoms of shingles in the eye when the infection reaches regions of the eye.
Skin Redness or Rash Around the Eye: Skin redness or a rash around the eye can develop as a symptom before the progression of blisters.
Blisters Around the Upper eyelid and One Side of the Forehead: Blisters around the upper eyelid and one side of the forehead can develop shortly after the initial pain, burning and tingling sensation during the early stages of shingles in the eye.
Burning, Throbbing, or Itching Around the Eye: Burning, throbbing or itching around the eye can occur as a symptom of shingles in the eye as onset symptoms before skin redness, rashes and blisters occur.
Extreme Skin Sensitivity: Extreme skin sensitivity can take place as a result of the shingles infection and can be defined as pain or stinging when affected areas of the skin are touched.

1. Blurry Vision

Blurry vision may occur as a symptom of shingles in the eye due to affected nerves in the head, causing the infection to reach the regions of the eye. Blurry vision can be defined as unclear vision that lacks details and defined shapes.

2. Eye Redness, Irritation or Tearing

Eye redness, irritation or tearing are common symptoms of shingles in the eye and can develop when the infection reaches the regions of the eye. Eye redness can occur from the infection due to the eye’s surface vessels enlarging. The eyes may experience eye irritation due to the redness which leads to tearing.

3. Skin Redness or a Rash Around the Eye

Skin redness or a rash around the eye is a common symptom of shingles in the eye and can develop after the initial burning and pain that typically occurs in the early stages. Redness or a rash around the eye is a common response due to inflammation from the virus infection.

4. Blisters Around the Upper Eyelid and One Side of the Forehead

Blisters around the upper eyelid and one side of the forehead can develop from skin redness and a rash around the eye. The blisters can appear as red or pink blotches of raised bumps filled with fluid, this stage typically takes place after redness and rashes start appearing on the skin.

5. Burning, Throbbing, or Itching Around the Eye

Burning, throbbing or itching around the eye can often arise as early signs of shingles in the eye before the appearance of redness and a rash on the skin. Burning, throbbing or itching occurs where the rash and blisters can likely develop. The symptom of burning can feel like a sharp and hot sensation on the skin. Throbbing can be characterized as a pulsing sensation on the skin.

6. Extreme Skin Sensitivity

Extreme skin sensitivity may occur with shingles in the eye due to the varicella-zoster infection causing an inflammatory response in the body. Extreme skin sensitivity may be described as pain or stinging in the skin when touched.

How Often Does an Adult Experience Shingles?

An adult may only experience shingles once, however, it is possible for it to reoccur. Shingles may typically occur around the age of 50 or older, however, it is possible to contract shingles at any age according to Health Direct.

How are Shingles in the Eye Diagnosed?

Shingles in the eye may be diagnosed by looking at the rash around your eye, eyelid, scalp and body by a doctor or optometrist. They may also ask if you have previously had chicken pox and will discuss your symptoms.

What are the Eye Exams Needed to Diagnose Shingles in the Eye?

The eye exams needed to diagnose shingles in the eye may be a slit lamp and ophthalmoscope. A slit lamp allows the optometrist to examine the inner structures of the eye and the front of the eye. An ophthalmoscope, also known as a fundoscopy, is a hand-held instrument that shines a light through the pupil. This allows the optometrist to evaluate the health of the back region of the eye.

How Do Shingles Get into Your Eyes?

Shingles can get into your eyes if the varicella-zoster virus is triggered in the trigeminal nerve, affecting the ophthalmic branch. The trigeminal nerve belongs to one set of cranial nerves and is responsible for bringing sensation to the face. The three branches of the trigeminal nerve are the ophthalmic, the maxillary and the mandibular.

What are the Potential Complications Associated with Shingles in the Eye?

The potential complications associated with shingles in the eye can include keratitis, cornea and retina swelling as well as increased pressure in the eye. Keratitis symptoms can present as redness in the eye, tears or discharge, pain and irritation and blurry vision. Swelling in the cornea can bring on the sensation of having something in your eye and cause pain and discomfort. Swelling in the retina may cause distorted or blurry vision according to the National Eye Institute.

Can Shingles in the Eye Lead to Permanent Vision Loss?

Yes, shingles can lead to permanent vision loss due to corneal scarring and damage to the retina. According to the National Library of Medicine, 1 in 10 individuals can experience moderate to severe vision loss, however, this may be a result of corneal scarring.

Are There Any Long-term Effects of Shingles on Eye Health?

Yes, long-term effects of shingles can include vision loss, scarring, the development of corneal blood vessels, uveitis, corneal ulceration and perforation. It is important to seek treatment for shingles in the eye to prevent long-term effects. If you are experiencing any of these symptoms, it is strongly advisable to seek urgent medical attention. The development of blood vessels in the cornea can occur due to inflammation caused by an infection. Uveitis is characterized as inflammation in the eye and can commonly develop due to an autoimmune condition. Symptoms of uveitis may include floaters in the eye, blurry vision, eye pain, vision loss and red eyes. Corneal ulceration and perforation is the thinning of the cornea caused by infection, which can lead to a rupture or a hole in the cornea. Other causes of corneal ulceration and perforation include keratitis, eye injuries, ocular surface diseases and autoimmune abnormalities. Symptoms can include vision loss, pain and excessive tears.

What are the Treatments for Shingles in the Eye?

The treatments for shingles in the eye include antiviral medication, eye drops, pain medication and a cool compress. The treatments for shingles in the eye are listed below.

Antiviral Medication: Antiviral medication can be taken as a tablet or in liquid form. It can help prevent the spread of the virus, reduce the rash and mitigate pain from the rash.
Eye Drops: Eye drops may be prescribed to help control inflammation, prevent further complications in the eye and maintain moisture.
Pain Medication: Pain medication may also be recommended to alleviate any symptoms of pain.
Cold Compress: Cold compress may be effective in easing itchiness, pain and discomfort. You can apply a cold compress by using a cold damp hand towel or a plastic bag with ice.

How Treatable are Shingles in the Eye?

Shingles in the eye is effectively treated by using antiviral medication as it can aid with delaying the further development of the virus and reduce symptoms. However, it is important to begin treatment as soon as possible.

What is the New Treatment For Shingles in the Eye?

There is currently no new treatment for shingles in the eye. However, NYU Langone Health Medical Centre is currently investigating new treatment processes for shingles in the eye through clinical trials.

Can Eye Drops be Used in Treating Shingles in the Eye?

Yes, eye drops can be used in treating shingles in the eye depending on the specific type and purpose. Eye Drops that specifically target viruses may prove effective in reducing symptoms of shingles in the eye and preventing the virus from progressing according to NVision Centres.

Woman inserting eye drops to alleviate symptoms of shingles in the eye.

What are Ways to Prevent Shingles in the Eye?

A way to prevent shingles in the eye may be to opt for the shingles vaccine as recommended by the Centers for Disease Control and Prevention (CDC). The shingles vaccine may increase the chances of preventing the development of shingles in the eye as it contains a weak form of the varicella-zoster virus. Recombinant Zoster Vaccine, RZV is currently the only vaccine authorized for use in Canada.

Is the Shingles Vaccine Effective in Preventing Shingles in the Eye?

Yes, the shingles vaccine is considered highly effective in preventing shingles in the eye for people aged 50 years and older. According to Medical News Today and the American Academy of Ophthalmology, the Shingrix vaccine has been proven effective by 90%.

Can Wearing Eye Glasses Help Prevent Shingles in the Eye?

No, wearing glasses may not help prevent shingles in the eye as it is caused by the reactivation of the varicella-zoster virus. If you previously had chickenpox, the virus will be dormant and present in the spinal nerve according to the Centers for Disease Control and Prevention (CDC).

Are Shingles in the Eye Contagious to Others?

No, shingles in the eye are not contagious to others, however, you may spread it to someone who has never had chickenpox before. Therefore it is important to practise good hygiene habits and avoid scratching or touching your rash.

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