Herpes zoster ophthalmicus (shingles in the eye)

What it is

Shingles occurs when the chickenpox virus reactivates in a nerve, often causing a painful blistering rash on one side of the face. When the nerve serving the eye is involved, the eye itself can become inflamed, risking corneal scarring, glaucoma and sight loss.

Warning symptoms

Eye involvement may not be obvious at first.

• Painful blistering rash on the forehead, scalp or tip of the nose
• Red, painful or light-sensitive eye on the same side
• Blurred vision if the cornea or inside of the eye is affected
• Flu-like feeling before the rash appears

Risk and urgency

A rash on the tip of the nose suggests a high risk of eye involvement. Anyone with shingles near the eye should have urgent eye assessment. Early antiviral tablets reduce complications, and the shingles vaccine lowers risk in older adults.

Treatment

Oral antiviral treatment started within 72 hours is key. Eye drops or further treatment may be needed for inflammation inside the eye. Long-term follow-up watches for glaucoma, scarring and nerve pain.