Herpes zoster ophthalmicus (HZO), also known as ophthalmic zoster, is shingles involving the eye. Symptoms generally include a rash of the forehead with swelling of the eyelid. There may also be eye pain, eye redness, and light sensitivity. Before the rash appears tingling may occur in the forehead along with a fever. Complications may include vision loss, increased pressure within the eye, and chronic pain.
The underlying mechanism involves a reactivation of the varicella-zoster virus within the ophthalmic nerve (the first division of the trigeminal nerve). Risk factors include poor immune function, psychological stress, and older age. Diagnosis is generally based on symptoms.
Treatment is generally with antiviral pills such as acyclovir. Steroid eye-drops and drops to dilate the pupil may also be used. The herpes zoster vaccine is recommended for prevention in those over the age of 50. Shingles affects up to half a million people in the United States a year of which 10% to 25% involve the eye.