Shingles is caused by the herpes zoster virus, the same virus that causes chicken pox. Aging, compromised immunity or other illness can cause the virus to awaken from dormancy. Shingles usually affects the torso, causing a painful rash with blisters. When shingles affects the eye, it is known as herpes zoster opthalmicus. Treatment includes oral antiviral medications and oral corticosteroids. It's important to seek treatment right away to prevent complications, including severe, recurring pain or relapses of the disease.
Patients with herpes zoster opthalmicus often complain of a flu-like illness that leaves them tired and achy, with a low-grade fever. These symptoms may last a week before the eruption of any lesions.
Herpes zoster opthalmicus attacks the trigeminal nerves, facial nerves in the forehead, eyelids and nose. Many people complain of pain in these areas before any rash appears.
The herpes rash usually initially appears on the forehead, upper eyelids and nose. The rash is made up of blisters filled with clear liquid, over extremely reddened skin. Eventually, these lesions will rupture and crust over.
Herpes lesions that appear on the side of the nose, the tip of the nose and the base of the nose at the eye are a strong indicator of herpes zoster opthalmicus. These lesions are known as Hutchinson's sign.
The conjunctiva of one or both eyes may swell and redden. Examination may reveal lesions. This typically occurs two to three days after the onset of the facial rash.
Lesions may also erupt on the cornea. They can be identified by applying a fluorescing stain to the eye and examining the eye with an opthalmoscope.
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