Shingles

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  Herpes zoster, commonly known as shingles, is a fairly common viral disease that most often affects people in middle age or older.  The unsightly rash of shingles can occur anywhere on the body, but the most common sites are the skin over the rib cage and the forehead.  The disease is always very painful.

  When the eye becomes involved, which can happen at the same time as herpes zoster of the forehead region, or afterwards, it can also threaten sight. The first symptom may be severe pain in the skin, followed in a few days by a rash and blisters in the affected area.  The blisters soon dry up and crusts and scabs form, eventually falling off and leaving irregular pink scars.  The rash almost always occurs on only one side of the body as a wide band following the path of a nerve.

  When the forehead, eyelid, or cheek is involved, the infection may extend down to the tip of the nose on the affected side.  It is then that the eyeball itself may become involved.  Vision may become blurry and the eye may become red, sensitive to light, and painful. The involvement of the eye in a herpes zoster attack can long outlast the original problem.  The scabs on the forehead may disappear in a few weeks, leaving some pock marks, but the skin inflammation, pain, and eye involvement may last many more weeks or even months.

  If the eye is involved, you will need intensive treatment to prevent serious damage to the eye and possibly to vision.  Eyedrops that contain a steroid to treat inflammation, and antibiotics to prevent secondary infection to the cornea may be prescribed.  You will need to be follow up closely for several weeks for other possible complications such as glaucoma, prolonged inflammation, and corneal scarring. If left untreated, herpes zoster of the eye may result in eyelid scarring, corneal scarring, cataract, chronic secondary glaucoma, or inflammation of the optic nerve.  All of these complications may result in serious and permanent damage to your vision.  Therefore it is imperative that you see an ophthalmologist for proper treatment.

 

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