Definition
Shingles in the eye or zoster ophthalmicus is caused by a reactivation of certain herpes viruses, the varicella zoster viruses. In the case of shingles in the eye, the reactivation of varicella zoster infection develops in the first branch of the trigeminal nerve, the ophthalmic nerve. Therefore, the symptoms develop in the forehead region and in the eyes.
Typical symptoms are the mostly unilateral skin changes, severe pain and possibly loss of sensitivity in the affected area, a reduced general condition and fever. Facial erysipelas of the eye carries a high risk of complications. If the eyes are also affected, corneal scars can lead to partial or complete blindness of the eye. Due to the threat of complications, early treatment with medication is particularly important in the case of zoster ophthalmicus.
Causes
Shingles in the eye is caused by the worldwide occurring varicella zoster viruses, which belong to the herpes viruses. The virus causes chickenpox during the so-called initial infection or primary infection. Once the disease has healed, however, the virus remains in certain nerve cell accumulations, so-called ganglia, for the rest of the patient’s life. A temporary immune deficiency, for example triggered by stress, tumor diseases, infectious diseases or immunosuppressive drugs, can lead to a reactivation of the virus and thus to shingles in the eye and face area. It is only possible to develop shingles if there has been previous contact with the virus in the form of a chickenpox infection or through a varicella vaccination.
Diagnosis
As a rule, shingles in the eye is diagnosed by a detailed anamnesis interview and the clinical appearance. If there is uncertainty in the clinical diagnosis or if the course of the disease is complicated, the pathogen can also be detected in the laboratory. However, this is usually not necessary, as the clinical findings are unambiguous due to the typical skin changes in certain areas, the general symptoms and medical history.
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