How contagious is shingles in the eye?

The danger of infection with shingles in the eye comes exclusively from the contents of the filled blisters. This is the big difference to the transmission of chickenpox. Although they are caused by the same pathogen, they are much more infectious, since chickenpox can also be transmitted via the air, i.e. aerogenously. In the case of shingles it is therefore sufficient to leave the affected area alone, treat it locally with anti-inflammatory or antiseptic agents and avoid scratching etc.

Shingles on the eyelid

If the eyelid is affected by shingles, it is called herpes zoster ophthalmicus.Since the entire ophthalmic nerve is affected, not only the eyelid but also the skin of the forehead or other parts of the eye, such as the cornea or conjunctiva, can be affected. Basically, the upper and lower eyelid can be affected. They then show a strong swelling with redness.

Usually only one half of the face is affected by shingles. The eyelids are usually affected at a very early stage in the case of herpes zoster ophthalmicus. If the eyelids are involved, numerous complications can occur. In addition to the death of some skin areas, so-called necroses, these include eyelid malpositions due to scarred healing. In rare cases, the tear ducts can also be affected, which can become narrowed and lead to increased lacrimation.

Shingles under the eye

If shingles affects the skin area under the eye, it is usually the second nerve branch (N. maxillaris) of the trigeminal nerve that is affected. This is called herpes zoster maxillaris. In addition to the usual skin changes, it can also spread to the bone and lead to the death of bone areas.

One speaks here of osteonecrosis. These can be accompanied by the loss of several teeth and usually require surgical intervention. Involvement of the nose, especially the tip, again indicates a subtype of herpes zoster ophthalmicus (so-called Hutchinson’s sign). This indicates an involvement of the eye, which can be accompanied by severe complications such as the death of the retina and thus a loss of vision.