![]() ![]() Diagnosis of ARN requires a careful eye exam by an ophthalmologist, and a sample may be collected from the inside of the eye for testing to confirm that the infection is caused by the varicella zoster virus. In contrast to patients with HZO or other forms of shingles that are associated with a skin rash, patients with ARN are often middle-aged and generally healthy. Viral retinitis can take the form of acute retinal necrosis (ARN) or progressive outer retinal necrosis (PORN). But it can significantly damage the retina through a combination of infection and inflammation. This type of shingles infection is called viral retinitis and occurs much less commonly than HZO. Shingles involving the retina or optic nerve - structures found at the back of the eye - typically is not associated with a skin rash or other symptoms at the eye surface. When started within 72 hours of the onset of symptoms, antiviral treatment also reduces the overall severity of the infection and the risk of post-herpetic neuralgia, a form of long-term pain that can occur after an episode of shingles. Treatment decreases the risk of later eye complications by about 40% to 60%. HZO, like episodes of shingles on other areas of the body, is typically treated with oral antiviral medications to address the underlying viral infection. Keratitis usually develops within one month of the shingles rash and can lead to numbness of the cornea, scarring, additional infections, and more corneal damage, which can ultimately cause blindness. If you have shingles involving the upper face, forehead, or scalp area, it is important to see an ophthalmologist for a formal eye examination, whether or not you notice any eye symptoms. More than half of patients with HZO may have keratitis. This is called keratitis, and it can occur as a complication of herpes zoster ophthalmicus (HZO), which refers to shingles with a rash that typically involves one side of the upper face, forehead, and scalp. ![]() Shingles can affect the cornea, the curved, transparent dome of tissue at the front of the eye. ![]() In some cases it can lead to vision impairment, including blindness. Viral infection of the eye can cause pain, drainage, redness, and sensitivity to light. Up to 20% of shingles episodes involve nerves of the head, where the infection can affect various parts of the eye, including the eyelid, the eye surface, and the deeper portions of the eye. About one million cases of shingles occur in the US each year. The risk of shingles therefore increases with any process that can weaken the immune system, including age, illness, and immune-suppressing medications. After the initial chickenpox infection resolves the virus lives on in nerves all over the body, but is kept in check by the immune system. Shingles is caused by reactivation of the varicella zoster virus, the virus that causes chickenpox. In fact, the name shingles comes from cingulum, the Latin word for girdle, belt, or sash. This rash appears along a particular affected nerve, for example in a band on one side of the chest or abdomen that extends around to the back. Shingles, or herpes zoster, is a viral infection known for its characteristic painful, burning, or itchy rash. ![]()
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