Herpes zoster, commonly known as shingles, is caused by reactivation of the varicella-zoster virus, the same virus that causes chickenpox. When this virus affects the nerves supplying the eye, it is called herpes zoster eye infection or herpes zoster ophthalmicus (HZO).
Because this condition can damage important eye structures and threaten vision, herpes zoster affecting the eye requires prompt medical attention.
How Herpes Zoster Affects the Eye
After chickenpox, the virus remains dormant in the body and may reactivate years later. During reactivation, it travels along a nerve on one side of the face. If the nerve serving the eye is involved, inflammation may affect:
- Eyelids
- Conjunctiva
- Cornea
- Uvea (inside of the eye)
- Optic nerve
Early diagnosis is essential to prevent long-term complications.
Symptoms of Herpes Zoster Eye Infection
Symptoms often begin with tingling or burning on one side of the forehead or eyelid, followed by a painful rash. Seek urgent eye care if you notice:
- Blistering rash on the forehead or eyelid
- Redness or swelling of the eye
- Light sensitivity
- Blurred vision
- Excessive tearing
- Pressure or pain behind the eye
- Severe, one-sided facial or eye pain
A rash on the tip of the nose (Hutchinson’s sign) strongly suggests eye involvement and requires immediate evaluation.
Possible Complications
Without timely treatment, herpes zoster eye infection may cause:
- Corneal ulcers or scarring
- Uveitis or iritis
- Increased eye pressure
- Secondary glaucoma
- Persistent nerve pain
- Partial or permanent vision loss
Prompt treatment greatly reduces these risks.
Treatment Options
Treatment is most effective when started within 72 hours of rash onset and may include:
- Oral antiviral medications
- Lubricating eye drops
- Steroid eye drops (only prescribed by an eye specialist)
- Pain-relief medication
- Monitoring of eye pressure
Regular follow-up visits are important to ensure healing and prevent complications.
Who Is at Higher Risk?
Herpes zoster eye infection is more common in:
- Adults over 50
- People with weakened immune systems
- Individuals under high stress
- Anyone who previously had chickenpox
Shingles vaccination significantly lowers the risk of herpes zoster and its eye-related complications.
If you are unsure whether your symptoms require emergency attention, it is safer to call your healthcare provider or eye clinic for advice.
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With a proven track record of excellence in glaucoma and cataract care, Dr. Mahnaz Shah and her team are here to help you protect your vision—with confidence.
