Ocular shingles is a dangerous form of shingles, which can result in serious complications. It is caused by the chickenpox virus, which affects the trigeminal nerve, including its first branch, which is the optic nerve. Shingles can even cause paralysis of the eyeball muscles and disturb your vision. What are the symptoms of ocular herpes zoster and how is it treated?

Ocular shingles( Herpes Zoster Ophthalmicus ) is caused by reactivation of the chickenpox virus -Varicella zoster (VZV) - dormant in the ganglia of the trigeminal nerve. The virus attacks its first branch - the optic nerve. Ocular shingles is a dangerous disease, approximately half of the patients develop complications, mainly those related to the organ of vision, such as:

  • keratitis
  • iritis
  • ciliary body inflammation

Rare complications include:

  • posterior uveitis
  • retinal vasculitis
  • acute retinal necrosis (ARN)
  • progressive external retinal necrosis (PORN)

and they can lead to serious visual impairment and even loss of vision.

Ocular shingles: symptoms

After the initial cold-like symptoms of shingles, there is a rash around the temple, eyelid and forehead - it runs along the affected nerve. Between the vesicles of the rough surface, filled with serous fluid, there are fragments of unchanged skin. From the very beginning of the disease, the patient complains of severe pain (neuralgia) that does not stop after using popular painkillers. The eye hurts and burns a lot. In 50 percent of cases, vesicles also occur on the conjunctiva and cornea. They cause ulcers there, which are easily infected with bacteria. The type of ulcer depends on at what point in the course of the disease it appears:

  • after 2-3 days of illness, superficial punctate keratitis may occur with accompanying loss of the corneal epithelium - they usually disappear without a trace
  • at the end of the first week, most patients develop microdendritic corneal ulceration
  • in the second week, pimple inflammation, i.e. circular cloudiness, may occurunder the corneal epithelium in its inner layers
  • after 2-3 weeks discoid keratitis may occur

Ocular shingles: treatment

Treatment of VZV keratitis depends on the extent of the lesions and the severity of the infection. For antiviral treatment to be effective, it must be started within 3 days of the onset of skin lesions. Usually, topical treatment with antiviral preparations (acyclovir, idoxyuridine) is used. The patient is also given steroid preparations (ointment, aerosol) for skin lesions. In severe eye complications, steroid drops are used. Whatever the cause, antibiotics are sometimes given to prevent secondary bacterial infections.

Ocular shingles: complications

In addition to the ophthalmic complications already mentioned, ocular shingles can cause neurological complications, including:

  • neuralgia - postherpetic neuralgia affects about 1/4 of patients, with about 5 percent suffering from it for more than six months
  • cranial nerve damage
  • severe headaches
  • myelitis
  • meningitis
  • encephalitis
  • Guillain-Barry syndrome
  • skin sensation disorders

Shingles: Causes and Symptoms

Shingles is a viral disease caused by the herpes zoster virus. Shingles is most common in adulthood, but it is also sporadic in children. What are the symptoms of shingles, who is susceptible to shingles, and what causes the activation of the virus?

Category:

Infectious diseases