Herpes Zoster Ophthalmicus

Causes

How do you get herpes zoster ophthalmicus? It’s caused by the same virus that triggers chickenpox—the varicella-zoster virus. After you have chickenpox, the virus can remain dormant in your body and reactivate later in life as shingles. In the case of HZO, it reactivates in the ophthalmic branch of the trigeminal nerve, which supplies sensation to the eye and forehead.

Aging, a weakened immune system, or stress can reactivate the virus. When reactivated, the virus moves along the nerve to the eye, causing inflammation and various symptoms.

Symptoms

The symptoms of herpes zoster ophthalmicus usually begin with pain, tingling, or a burning sensation on one side of the face.

These initial symptoms may be followed by:

• A rash or blisters around the eye, forehead, and sometimes the tip of the nose
• Redness and swelling
• Sensitivity to light, or photophobia
• Blurred vision
• Discharge from the eye

Various types of eye inflammation can develop, including:

• Keratitis, or inflammation of the cornea
• Uveitis, or inflammation of the uvea
• Scleritis, or inflammation of the sclera
• Conjunctivitis (pink eye), or inflammation of the conjunctiva

Without prompt treatment, HZO can cause serious issues like corneal ulcers or even vision loss.

Diagnosis

To determine if you have herpes zoster ophthalmicus, you’ll need an eye exam. Your eye doctor may be able to verify the condition if you have the characteristic rash and blisters around your eye and forehead.

If your doctor has concerns about vision complications, they may conduct tests to assess the extent of eye involvement. They may check your eye pressure and examine your cornea for signs of inflammation. Additional tests, like culture or polymerase chain reaction (PCR) studies, are only done when lesions are unusual and the diagnosis is unclear.

Treatment Options

Wondering how to treat herpes zoster ophthalmicus? The main goal is to reduce pain, manage symptoms, and prevent complications. Doctors typically prescribe antiviral medications (e.g., acyclovir, famciclovir, or valacyclovir) to help shorten the duration of the outbreak and lessen its severity.

Pain relievers and corticosteroids may also reduce inflammation and discomfort. More intensive treatments might be necessary in severe cases, especially if the cornea is affected.

If you think you might have herpes zoster ophthalmicus or have any other vision health concerns, schedule an eye exam with Visionworks today!