"Herpes zoster" not only "hists the waist" but also "hists the eyes" - Popular science about the eye complications of herpes zoster

Author: Chen Di, deputy chief physician/associate professor, Peking Union Medical College Hospital

Reviewer: Chen Youxin, Chief Physician/Professor, Peking Union Medical College Hospital

"Herpes zoster", also known as "snake sores", "snakes", "herpes zoster", etc., is called herpes zoster in modern medicine. It is an acute infectious skin disease caused by the varicella-zoster virus. Although this is a skin disease, some patients' herpes zoster will grow on the eyes. Herpes zoster will not only "wrap around the waist", but also "wrap around the eyes", causing eye lesions. So, which herpes zoster patients need to see an ophthalmologist? Is the probability of eye complications of herpes zoster high? What are the symptoms and sequelae? How to avoid or reduce eye complications? This article will give a brief popular science introduction to these issues.

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1. What are the typical symptoms of shingles patients?

Skin symptoms in people with shingles include:

(1) Blisters: The most common symptom is the appearance of clusters of red papules on one side of the body, which quickly turn into small blisters (blisters) filled with clear fluid.

(2) Pain: Before blisters appear, the affected area may feel burning, stinging, or very sensitive, or even painful to the touch.

(3) Itching: After the blisters burst, you may feel itching.

(4) Rash: The blisters will eventually dry and form scabs, but temporary scars may be left in the process.

In addition, some patients may have accompanying symptoms, such as fever (some patients may have a low-grade fever), fatigue (feeling tired or weak), headache, and swollen lymph nodes (lymph nodes in the neck, armpits, or groin).

2. Which shingles patients need to see an ophthalmologist?

If shingles develops on the head or face, especially the upper eyelids, the base of the nose, the brow ridges, and near the forehead, it usually affects the eyes. If blisters appear in these areas, you need to see an ophthalmologist.

3. Is there a high probability of eye complications from shingles?

Foreign research data shows that among patients with herpes zoster, 10% to 20% will have eye involvement, and this probability will increase with age. Therefore, it is not uncommon for herpes zoster to affect the eyes.

4. What are the symptoms and sequelae of shingles affecting the eyes?

The main symptoms of herpes zoster involving the eyes include red eyes, eye pain, photophobia, tearing, foreign body sensation, etc.; some patients may experience double vision, inability to lift their eyelids, etc. In most cases, herpes zoster does not affect vision, but some patients may become blind due to serious complications. Patients with serious eye complications often have low immunity. In addition, the vast majority of herpes zoster eye lesions only affect one eye, and it is rare for both eyes to be affected at the same time.

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5. How to avoid or reduce eye complications?

(1) Try to avoid recurring episodes of shingles, actively treat and control the original disease, and improve your own immunity.

(2) If herpes zoster appears on the head and face, especially near the root of the nose and the brow arch, you need to seek medical attention promptly and actively treat eye complications.

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(3) For people who are prone to relapse, the probability of recurrence of shingles can be reduced through vaccination.