Shingles in the Eye

Shingles is well known as something that affects older people but there is a great deal of misunderstanding about what it actually is. One common belief is that it is possible to catch shingles from someone with chicken pox – but this is not true. Shingles and chicken pox are caused by exactly the same virus but while chicken pox is caught, usually in childhood, shingles is not. Shingles only occurs in older people who had chicken pox when they were younger.

Herpes zoster, the virus that causes chicken pox, stays in the body long after the spots and other signs of infection have cleared up. It stays dormant inside the nerves near to the spine, held in check and kept under control by the immune system and the specific immune response to the virus. The trouble is that, as time goes by, the body’s immunity to the herpes zoster virus starts to decrease. Unless, as an adult, you are exposed to chicken pox again, your immunity to it gets lower. At some point, in your 50s, 60s, 70s or older, the virus is no longer held in check. It multiplies in the nerves and erupts out into the skin. This is why shingles causes a rash and spots along one side of the body usually – it follows the line of the nerve endings.

Shingles and the Eye

Shingles can be very distressing, causing a large outbreak of spots along the body. Often, if affects the face and head, erupting at the side of the face and on the outer and inner structures of the eye. Ophthalmic shingles is very painful and can cause long term damage to the nerves and delicate structures in the eye.

After Effects of Shingles

As well as causing long-term damage to vision, the virus also damages nerves. This creates a condition called post-herpetic pain, which is common after shingles. The traumatised nerves feed pain signals to the brain all of the time, even thought the spots heal and disappear. Post herpetic pain never goes away and there are very few treatments that can make it go away. Older people who are otherwise fit but then develop shingles lost much of their quality of life afterwards, because of eyesight problems and chronic pain.

A Shingles Vaccination

A shingles vaccine has been developed and has been approved by the FDA in the US, and by the regulatory authorities in the UK. As in so many instances, however, because the vaccine costs more per dose than the average vaccine, it has not yet been accepted for widespread use. There are plans to make it available for people aged 70-79 from January 2011, but many people argue this is too restrictive. If it could be used for everyone over 60, and then given to people as they reach 60, this would be cost effective as it would save the healthcare costs of providing medication and care for the older people who would have developed post-herpetic pain and long-term eye problems.

Antiviral Treatment

Currently, in the UK, the only option that could help someone who starts to develop shingles, it to receive a dose of an antiviral drug within 72 hours of first showing symptoms. This has been shown in clinical trials to make the shingles less severe and also to lessen the risk of eye damage and post-herpetic pain.