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Eye and Vision Care

Herpes Zoster and Vision

12/30/2009

Question:

What affects does herpes zoster have on the eye, and what is the best means of preserving your vision, while treating the herpes zoster?

What measures and precautions should one take when treating this problem?

Answer:

This is a great question.

Herpes Zoster(HZ), also known as "shingles," is a viral infection that affects the skin but can also affect the eye. It usually presents as a sore eye on one side but not the other. This asymmetry (ie, affecting one eye but not both) is important in the eye doctor's differential diagnosis.

Unlike a bacterial infection which causes a red eye and a mucopurulent (mucous and pus) discharge and usually affects both eyes, the HZ eye infection is inside the eye. The technical term for this is iritis (eye-RYE-tous) or anterior uveitis (you-vee-EYE-tis).

When detected by an eye doctor, it is usually treated with two eyedrops; an anti-inflammatory steroid and a dilating drop to keep the pupil enlarged. The patient is very sensitive to bright lights during this treatment, so wearing sunglasses is a good idea. 

If systemic anti-viral medicines have begun within 48 hours of onset, there is less chance of the HZ virus affecting the eye.

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Response by:

Robert D Newcomb, OD, MPH, FAAO Robert D Newcomb, OD, MPH, FAAO
Professor Emeritus of Clinical Optometry
College of Optometry
The Ohio State University