Shingles in the eye is called ophthalmic herpes zoster or herpes zoster ophthalmicus. It can cause scarring, vision loss, and other long-term problems. Early diagnosis may make a difference.

The varicella-zoster virus causes chickenpox and shingles. Once you’ve had chickenpox, the virus stays dormant in your system. It can reemerge later as shingles.

Woman with shingles in the eye spreading from foreheadShare on Pinterest
A blistering rash on one side of the face is considered a medical emergency, even if it has not compromised the eye yet. (1918703530 apomares/Getty Images)

Shingles often affects one eye only. It is the result of the varicella-zoster virus reactivating in one of the cranial nerves, specifically the trigeminal nerve. This nerve manages sensations in your face and scalp.

Shingles travels through nerve paths and affects the areas the nerve supplies.

When you have shingles in the eye, you may start feeling a burning sensation or you may notice reddening or irritation in or around the affected eye. It may start on the forehead, nose, or eyelids.

At first, you may notice swelling and sensitivity on your eyelids, forehead, and possibly on the tip or side of your nose (Hutchinson’s sign). You may notice some redness or change in skin coloring as well.

After a few days, you may see small blisters developing in these areas, usually on one side of the face only. Some people have symptoms in the eye only.

Along with the rash, you may also experience:

  • burning or throbbing pain in the eye
  • severe redness around and in the eye
  • tearing or watery eyes
  • eye irritation that doesn’t go away when you wash it
  • blurry vision
  • extreme sensitivity to light

You may also have swelling in parts of your eye, such as:

  • eyelid
  • retina, which is the light-sensitive layer in the back of your eye
  • cornea, which is the clear layer in the front of your eye

If you have one or more of these symptoms, particularly if you experience irritation and pain in the eye, immediate medical attention is needed. Shingles in the eye may lead to complications, like vision loss. Early diagnosis improves the outcomes.

Common shingles symptoms

Early signs of shingles often include a tingling sensation or burning pain on one side of the body. It may feel as if something was constantly rubbing against your skin.

Common shingles locations include:

  • waist
  • back
  • chest
  • ribcage

Other general early signs may include:

  • headache
  • fever
  • fatigue
  • flu-like symptoms

Within a few days of the first signs, a rash may develop in the area where you first felt irritation. The rash may look like clusters of tiny fluid-filled blisters. They may ooze and bleed. Eventually, the rash crusts over and starts to heal. A shingles rash may last up to 5 weeks.

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A rash caused by shingles may resolve within 5 weeks, but some people may continue experiencing pain for weeks or months. This common complication of shingles results from nerve damage and it’s called postherpetic neuralgia. In most people, the nerve pain will get better over time.

In shingles of the eye, swelling of the cornea may be severe enough to leave permanent scars or damage. Shingles can also cause swelling of the retina and may increase eye pressure and lead to glaucoma. Glaucoma is a disease that damages the optic nerve.

Treating shingles in the eye as soon as you experience early signs may help reduce the chance of long-term problems, including permanent vision loss.

An experienced healthcare professional may diagnose shingles just by looking at the rash on your eyelids, scalp, and body. They’ll ask you if you ever had chickenpox, as only those who have had chickenpox develop shingles.

A medical professional may also take a sample of fluid from the blisters, if you have an active rash, and send it out to a lab to confirm the varicella-zoster virus.

An eye doctor will likely examine your face, including:

  • cornea
  • eye lens
  • retina
  • surrounding areas of your eye

Healthcare professionals typically manage shingles with antiviral medications, such as:

  • acyclovir (Zovirax)
  • famciclovir (Famvir)
  • valacyclovir (Valtrex)

These drugs may:

  • reduce the severity of your symptoms
  • decrease the rash and symptom duration
  • help the blisters heal
  • prevent complications
  • make the rash less likely to infect other people

Starting treatment within 72 hours of your first signs can help you avoid long-term shingles complications.

To reduce swelling in your eye, your healthcare professional may also prescribe oral corticosteroids or eye drops.

If you develop postherpetic neuralgia, pain medication and antidepressants may help you manage nerve pain.

Shingles may resolve within 5 weeks. Symptoms involving your face and eyes may sometimes take a few months to resolve, though.

In the early stages of shingles in the eye, your healthcare professional may want to see you every few days to monitor the progression of the rash. This reduces the chances of complications with the structures of your eye.

After shingles resolves, you may need to see an eye doctor within 12 months to check for signs of glaucoma, scarring, and other long-term problems that may affect your vision.

The shingles vaccine may reduce the chance of you developing shingles anywhere in the body, including your face. You may want to discuss the vaccine with your healthcare professional to learn more about its effectiveness and use.

If you’ve had chickenpox, avoiding direct contact with an active shingles rash is highly encouraged. You can only get shingles if you’ve had chickenpox before. If you haven’t and become exposed to the varicella-zoster virus, even as an adult, you may first get chickenpox and not shingles.

Shingles may develop anywhere in the body, including your face and eyes. Only people who’ve had chickenpox can develop shingles.

Shingles in the eye may start with an irritation in and around the eye that gradually becomes a painful or itchy rash. Seeing a healthcare professional as soon as you notice symptoms is highly advised to reduce the chance of complications like vision loss.