Spotting Shingles in the Eye: Pictures, Care, Outlook, and More

Medically Reviewed By William C. Lloyd III, MD, FACS
Was this helpful?
8

Shingles in the eye results from infection by the varicella-zoster virus, which affects areas all over the body. Shingles in the eye is also called herpes zoster ophthalmicus or ophthalmic herpes zoster. It can cause burning pain, swelling, redness, and blurred vision. Shingles is a viral infection that often presents as a band of rash or painful blisters. It can develop in any part of the body, including the eyes.

In the United States, about 1 in 1000 people develop shingles every year. Around 8–20% of those who develop shingles experience herpes zoster ophthalmicus.

This article discusses shingles in the eye, its symptoms, causes, and complications. It also explains the treatment and prevention of the infection.

What is shingles in the eye?

Extreme close-up of a person's face, showing a person's eye and upper face, highlighted by a beam of light.
Namukolo Siyumbwa/Stocksy United

Shingles can occur if a person has previously had a chickenpox infection. The virus, called varicella-zoster, stays dormant in the nerves. However, it can reactivate in some people, causing shingles.

The now active virus can start to replicate again. It will shed viral particles that travel along the nerves.

Shingles can affect the eye area when the virus impacts a nerve around the eyes.

This type of shingles does not necessarily always affect the eye. However, ocular symptoms occur in around 50% of herpes zoster ophthalmicus cases.

Shingles in the eye may cause vision problems, eye pain, and other complications.

Learn more about shingles, including how it develops and its transmission, at our online shingles information center.

What does shingles in the eye look like?

Shingles in the eye often affects just one eye or one side of the face.

The infection typically starts with pain in or around the eyes. It can develop into a red rash on the skin, then into lesions or fluid-filled blisters. These blisters eventually scab or crust.

The lesions may appear on:

  • the eyelid or periocular skin, the skin around the eye
  • the retina, the thin layer at the back of the eyeball
  • the cornea, the transparent, front-facing part of your eye

Shingles in the eye may cause additional ocular conditions, such as uveitis, keratitis, retinitis, and conjunctivitis (pink eye).

These conditions may cause the eye to appear pink or red. The eye may also be inflamed or appear discolored with visible blotches or lesions.

Ocular symptoms

Symptoms of eye conditions that occur due to shingles can include:

  • eye pain or aching, either in or around the eye, especially when focusing
  • swelling in or around the eye
  • itching, irritation, or burning sensations
  • sensitivity to light
  • blurred, clouded, or decreased vision
  • floaters, small shapes moving across your vision
  • worsening of peripheral and central vision, vision in dark conditions, and color vision
  • tears or discharge from the eye, which may cause crusting of the eyelids or lashes
  • difficulty opening the eyelid due to pain or irritation
  • the sensation that something is in your eye
  • discomfort or difficulty using contact lenses

Seek emergency medical treatment for eye symptoms

Shingles in the eye can cause permanent damage, vision loss, and other complications. Therefore, it is essential to receive medical treatment as soon as possible to avoid any further effects on health.

Seek emergency treatment or call 911 for any eye-related symptoms.

Pictures

Here are some photos of what shingles can look like when it affects the eye and eye area.

shingles-body1.jpg

Shingles in the eye

Ophthalmic herpes zoster presents around the eye with redness and discoloration.

VideoBCN/Shutterstock

day-shingles-body2-1.jpg

Shingles in the eye

Shingles around the eye can present with eye redness, swelling and blisters.

Burntfingers, CC BY-SA 4.0, via Wikimedia Commons

eye-shingles-body3.jpg

Shingles in the eye

Ophthalmic herpes zoster can also cause numbness and tingling of the face.

ARZTSAMUI/Shutterstock

shingles-body4-1.jpg

Shingles in the eye

Classic shingles rash around the eyes, forehead and nose.

imageBROKER / Alamy Stock Photo

Other symptoms of shingles in the eyes

Shingles in the eye can also accompany other symptoms that affect other areas of the body.

Shingles in the eye may also cause a rash around the eye area. This rash can affect the eyelids, brow, nose, side of the face, cheek, or forehead.

Additional symptoms of shingles include:

The Hutchinson sign indicates that shingles is affecting the nasociliary nerve, a sensory nerve to the eye. The sign appears as a rash or blistering around the tip of the nose. Even if the eye does not appear impacted, eye doctors know to expect additional symptoms if they observe the Hutchinson sign.

When to seek medical help

Contact a doctor immediately for any eye-related symptoms that accompany other signs of shingles.

An ophthalmologist may also be able to diagnose and care for your eye symptoms.

Is shingles in the eye an emergency?

Shingles, and shingles in the eye, can be serious conditions. Both conditions can require emergency assistance.

Shingles is especially serious in the following groups of people: 

  • pregnant people
  • infants less than 1 month old 
  • people with a weakened immune system

Additionally, shingles in the eye can result in vision impairment or loss. The risk of vision impairment increases without prompt treatment.

Seek immediate medical help for any symptoms with shingles, vision problems, or eye lesions. An early diagnosis increases the chance of successful treatment.

Diagnosis

To diagnose shingles in the eye, your doctor will first conduct a physical exam. They will also ask about your medical history and symptoms.

In some cases, your doctor can diagnose the condition based on symptoms alone.

However, further tests may be necessary in cases where the rash is not as distinctive. For shingles in the eye, a diagnosis may involve swabbing the eye or taking a fluid sample from it.

How do you treat shingles in the eye?

Treatments for shingles in the eye will aim to alleviate symptoms and prevent complications.

Doctors may prescribe antiviral medication to address the viral infection. These can include acyclovir, valacyclovir, famciclovir, and foscarnet.

Your specific treatment may depend on individual factors, such as whether you have a compromised immune system.

Other treatments are available on a case-by-case basis. If necessary, doctors may recommend additional treatments, such as:

  • medications, including antibiotics or corticosteroids
  • antidepressants for nerve pain
  • eye surgery or debridement

At-home care

Some over-the-counter and at-home treatments may also help improve symptoms of shingles.

These can include nonsteroidal anti-inflammatory drugs or pain relievers, such as ibuprofen and paracetamol. A cool compress may also help provide relief.

If you have a rash or blisters, keep the affected area clean and avoid unnecessary touching to reduce the risk of infection.

How long does shingles in the eye last?

According to the National Institute on Aging, shingles generally takes 3–5 weeks to clear.

However, recovery may leave a few minor scars behind. Additionally, untreated shingles in the eye could cause lasting damage. Complications that result from this condition could also have a lasting impact.

Contact your doctor promptly for any new symptoms or if your symptoms do not improve with treatment.

Complications of shingles in the eye

In severe cases, or with ineffective treatment, shingles in the eye can have serious health implications, such as:

  • postherpetic neuralgia
  • permanent vision loss 
  • prolonged eye scarring
  • glaucoma
  • corneal damage 
  • nerve damage
  • necrosis
  • further infection

In rare cases, shingles and shingles in the eye can also cause damage to the brain and spinal cord. This damage increases the risk for further complications, such as stroke, meningitis, and death. Prompt, aggressive treatment for these complications is essential to preserve a healthy central nervous system.

To lower your risk of complications, consider:

  • seeking early treatment
  • following your treatment plan
  • monitoring your symptoms and informing your doctor of any changes

Prevention

The Centers for Disease Control and Prevention (CDC) recommends taking the shingles vaccine if you have previously had chickenpox. 

You can also receive a chickenpox vaccine if you have never had chickenpox.

The vaccine can lower your risk of infection by around 90% in the first 7 years. It can also help reduce the severity and duration of symptoms if you do develop shingles.

Contact your doctor regarding vaccination to find out how to get it and to see if it could help you.

Outlook

The outlook for those with shingles in the eye can vary depending on individual factors. These factors include the person’s previous condition, how quick and effective treatment is, and the severity of the infection.

For most people with no underlying immune conditions who receive early treatment, the outlook is positive.

This outlook includes improvement of symptoms within 4 weeks and successful management with outpatient treatment.

Other cases may need further treatment, more time to resolve, or may result in complications.

Summary

Shingles is a viral infection that causes painful skin blisters. It can affect many different parts of the body, including the eyes.

Shingles in the eye can present as pain, redness, sensitivity to light, and blurred vision. Shingles may cause other symptoms and irritation.

To treat the infection, your doctor may prescribe antiviral medication. Early treatment is essential, as complications of shingles in the eye can include vision loss. Some complications can be life threatening.

Consult your doctor or ophthalmologist for evaluation and treatment if you have symptoms of shingles anywhere around the eye.

Was this helpful?
8
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 May 19
View All Shingles Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.