Herpes zoster, commonly known as “shingles,” is a viral disease that causes a characteristic skin rash of small fluid-filled blisters (vesicles), which form scabs and can leave permanent scars.

The first symptom is often severe pain or itching, followed by redness of the skin, and finally the appearance of a few or many of the characteristic blisters. The distribution of the blisters follows the route of the infected nerve.

Pain is often severe, accompanied by burning, throbbing and extreme skin sensitivity. The rash lasts 3 to 6 weeks, but some people experience pain months or years later. This extended involvement is called “post-herpetic neuralgia.”

Vericella zoster, the same virus that causes chicken pox, is responsible for herpes zoster. After years of dormancy, the virus re-activates, usually attacking older people or those with reduced immunity.

How Herpes Zoster Affects the Eye

Herpes zoster commonly attacks the nerves around the eye, especially the nerve that supplies the upper eyelid and forehead.

If the virus affects the nerves that go directly to the eyeball, it can cause serious eye problems, including corneal ulcers, inflammation and glaucoma.

These problems may appear at the same time as the skin rash or weeks after the vesicles have disappeared. Lingering pain is the result of injured sensory nerves, which may remain overly sensitive for years after the attack. Rarely, eye movement, the retina, or the eye nerve are also affected.

The usual procedure is to control pain and prevent further skin infection with soaks, scrubs and other treatments. Antiviral drugs, steroids taken by mouth, or other medicines may be helpful in some circumstances. If the eyeball is affected, eye drops, eye ointments or oral medication may be necessary.

Most people recover without complications. Unfortunately, despite available medicines, some people have permanent visual damage and continue to have pain even after the skin rash has gone away.