Treatment for Shingles in Eyes

Shingles is a secondary condition of infection with the varicella-zoster virus (VZV), the same virus that causes chickenpox. After infection with chickenpox, VZV becomes dormant in some of the body's nerves and reactivates later, affecting the nerve along which it became dormant. Although shingles typically appears on the buttocks and trunk of the body, other areas, including the face and eyes, sometimes become involved. Treatment for shingles in the eyes treats shingles and the associated pain while also trying to limit damage to the eyes, as herpetic conditions of the eyes can lead to serious complications.

General Treatment for Shingles

• The primary treatment for shingles is the administration of antiviral drugs (acyclovir, valacyclovir or famciclovir) along with corticosteroids. Antiviral drugs target the virus directly, while corticosteroids are used as an anti-inflammatory to limit nerve damage; this combination of therapies is also effective in relieving the pain of shingles.

Ocular Involvement

• According to Seth John Stankus, M.A.J., M.C., et al., the primary treatment for shingles affecting the eye is the same as that for general shingles, a course of antivirals and corticosteroids. However, Dr. Stankus notes that those with eye involvement in shingles should be referred to a specialist. According to the University of Maryland Medical Center, a rash on the side of the nose is a risk factor for developing shingles symptoms in the eyes.

Complications

• According to Stankus, et al., complications of ocular shingles include conjunctivitis with a discharge or mucus and pus, inflammation of the episclera, inflammation of the cornea (keratitis) and of the iris and surrounding tissue (anterior uveitis). Complications of ocular involvement in shingles can sometimes lead to loss of vision.

Treatment of Complications

• According to Anthony J.H. Hall, M.D., corneal complications of shingles may not require treatment beyond antivirals and corticosteroids; however, some may require the eye to be lubricated along with the possible use of topical corticosteroids, and surgery may be required to correct loss of feeling in the cornea. Dr. Hall also reports that eye drops with corticosteroids and those used for dilating the eye are used in the treatment of uveitis. Other conditions are treated based on whether they arise directly from shingles or are secondary.