Definition: Ophthalmic herpes zoster is a shingles outbreak that occurs on the ophthalmic division of the fifth cranial nerve. In rudimentary terms, it’s a shingles outbreak that occurs on the face, scalp, forehead, nose, eye, or combination of any of those parts. The forehead is the area that is most frequently affected by ophthalmic herpes zoster.
In rare cases, no identifiable shingles outbreak will occur, and only the eye will be affected. Comparatively, it’s quite common for the eye and face to be affected simultaneously. The complications of this variation of shingles can be particularly dangerous, especially in cases when the eye in involved.
There are a wide variety of eye problems that can occur as a result of Ophthalmic herpes zoster, which is why it’s important to see a doctor immediately if you suspect you have the affliction.
Symptoms of Ophthalmic Herpes Zoster
Early symptoms of the disease may include fatigue, depression, chills, fever, or flu-like symptoms. Tingling sensations on one side of the face or scalp — where the rash will likely appear — are also common early symptoms.
These preliminary symptoms of ophthalmic herpes zoster may only last a few hours, or they could last as long as a week, according to some studies. Eventually, a rash will appear on most patients (it’s very rare that a patient won’t develop a rash, but this has been reported).
When the rash appears, it will be blistery and fluid-filled, and it will typically appear somewhere on one side of the face — usually around the forehead, as was mentioned earlier.
Huntigton’s sign, or noticeable blisters/lesions around the side, root, or tip of the nose is often an indicator that there the disease is also affecting the eye.
Treating Ophthalmic Herpes Zoster
Antiviral drugs are the most common and effective treatment for ophthalmic herpes zoster. These antiviral drugs are also used to treat standard variations of the disease (related: Shingles Treatment Options). The three most commonly prescribed antiviral drugs include: acyclovir, famciclovir, and valacyclovir.
It’s important that these medications are administered within three days of the shingles outbreak. Moreover, sooner is better, so seeking medical treatment immediately is usually recommended.
Oral corticosteroids are another treatment option considered for patients experiencing significant pain. However, these are usually only a viable option for healthy patients, as corticosteroids have many side effects, and they can be dangerous for patients with certain preexisting conditions.
In most cases — especially if the eye is not affected and antiviral treatment is sought early — the risk of complications is relatively rare. However, postherpetic neuralgia (prolonged pain after the outbreak) is a more serious risk for those who develop this condition, so patients should make sure to consult with their doctor if they continue to experience symptoms after the treatment course has been administered.