A person with shingles will usually break out in a painful rash that spreads across the upper body. However, it is possible for shingles to develop on the face and in the eye. If this happens, the condition can cause vision problems that can be very serious.

People cannot develop shingles unless they catch the varicella-zoster virus, which also causes chickenpox. Once a person has experienced chickenpox, the virus will remain with them.

In some people, the varicella virus stays dormant. In others, it becomes active and causes shingles. The virus can become active again and again throughout a person’s lifetime.

In this article, we describe the symptoms of shingles and how the condition can affect the eyes and vision. We also explore treatment options, complications, and tips for prevention.

Symptoms of shingles

Shingles in the eye swelling
A person with shingles of the eye may experience blistering on the upper eyelid.

Shingles, or herpes zoster, can cause several symptoms. Often, the first is pain.

Shingles pain can feel different to different people. Some experience a dull throbbing while others experience a sharp stabbing or burning sensation. The pain may be constant or come and go.

Another common symptom is a rash that usually forms as tiny blisters. These can be sore and itchy. The rash usually develops in bands across a person’s upper body, but it can also appear on the face.

Additional symptoms of shingles include:

  • headache
  • nausea
  • muscle and joint weakness or pain
  • fever or chills
  • difficulty urinating
  • tiredness
  • swollen glands (lymph nodes)

More severe complications of shingles can include pneumonia, inflammation of the brain, and death. These are rare and usually only occur in people with weakened immune systems.

Symptoms of shingles on the face

If the shingles rash develops on a person’s face, they may experience:

  • difficulty moving parts of their face
  • drooping eyelids
  • a loss of hearing
  • problems with taste
  • problems with vision, including the inability to move the eye

Symptoms of shingles in the eye

The medical term for shingles in the eye is herpes zoster ophthalmicus.

Symptoms of shingles in the eye include:

  • blistering on the upper eyelid, usually on only one side of the face
  • redness and swelling around the eyelids
  • itchiness and irritation of the eye
  • sensitivity to light
  • blurred vision

Around the eye, a person may experience:

  • burning pain
  • redness or a rash
  • skin sensitivity

While these symptoms can indicate shingles, they can also characterize other eye conditions. Anyone with any of these symptoms should seek urgent medical attention.

Shingles in the eye can cause severe complications, such as corneal ulcers, inflammation, and glaucoma.

How shingles can get into the eyes

Other names for the varicella-zoster virus include VZV and the chickenpox virus.

After the symptoms of chickenpox have cleared up, the virus lies dormant in the body. At any time, the virus could reactivate and cause shingles to develop.

The virus lives in a person’s sensory nerves, and the pain it causes can be severe.

When shingles affects a person’s facial nerves, they can experience eye-related symptoms.

How is shingles in the eye diagnosed and treated?

Drops for shingles in the eye
Using eye drops can help fight inflammation and dilate the pupil.

Anyone who suspects they have shingles in their eye should go to the emergency room or visit their primary care doctor or eye doctor as soon as possible. Shingles in the eye can lead to vision loss.

A doctor usually only needs to perform a physical examination to make a diagnosis. They may also take a sample of fluid from a blister and send this for testing. Results will determine if it contains the virus that causes shingles.

After confirming a diagnosis of shingles, the doctor will prescribe antiviral medication.

The medication can come in liquid or tablet form. Take it as soon as possible for maximum effectiveness.

If a person has a weakened immune system, the doctor may admit them into a hospital for intravenous antiviral medication.

To help manage the pain, a doctor may also recommend eye drops that fight inflammation and dilate the pupil.

Risk factors for shingles

Shingles affects around 1 in 3 people in the United States.

Anyone who has experienced chickenpox can develop shingles, but it is more common in people over 50 years old.

There is no clear reason why the virus reactivates. Some risk factors may include:

  • being older
  • having a lot of stress
  • having another illness
  • having a weak immune system

A vaccine can immunize people against shingles.

Complications

Shingles in the eye poses risk to pregnant woman
Shingles is particularly dangerous during pregnancy as the fetus can contract the virus through the blood.

Some cases of shingles go away by themselves.

However, shingles in the eye can cause serious complications, such as:

  • glaucoma
  • corneal ulcers
  • scarring
  • acute retinal necrosis, a severe disease that can cause blindness

Shingles can be more dangerous during pregnancy. The fetus can contract the virus through the blood. Also, infants born prematurely can have an increased risk of serious complications if they develop shingles.

Doctors recommend that people over 50 receive the shingles vaccine due to the severity of possible complications and because the condition mainly affects older adults.

The most common complication of shingles is postherpetic neuralgia, which is pain that lasts 3 months after a rash first appears. The pain can be mild or severe.

Prevention

The most effective way to prevent shingles is by getting the vaccine.

The Centers for Disease Control and Prevention (CDC) recommend vaccination for people aged 50 years and older.

The CDC recommend two vaccines for shingles: Shingrix and Zostavax. Of the two, the CDC prefer Shingrix.

According to the CDC, Shingrix is 97 percent effective at preventing shingles in adults aged 50–69 who received two doses.

In adults aged 70 and older who received two doses, Shingrix is 91 percent effective at preventing the condition.

Shingles is contagious. If a person has the condition, it is essential that they avoid contact with people who have never had chickenpox.

The contagious stage is over when the blisters on the skin have healed. This can take 2–4 weeks.

If a person first contracts the varicella-zoster virus from someone with shingles, they will develop chickenpox, not shingles.

To minimize the chances of passing on the virus:

  • Keep the shingles rash covered.
  • Try not to scratch it.
  • Practice good hygiene, especially by washing the hands after touching the rash.

Outlook

Shingles in the eye is a severe condition. If the shingles rash develops on the face, seek medical attention right away.

Prompt treatment with antiviral medication can help to relieve symptoms and prevent complications.

Eye-related complications of shingles can be very serious. Anyone who suspects that they have shingles in the eye should receive urgent medical attention.