A person with shingles will usually break out in a painful rash on their upper body. However, shingles can also develop on the face and in the eye. If this happens, the condition can cause vision problems that can be very serious.

Shingles can affect different parts of the body, including the face and eyes. People cannot develop shingles unless they contract the varicella-zoster virus, which also causes chickenpox. Once a person has experienced chickenpox, the virus will remain in their body.

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.

Other names for the varicella-zoster virus are “VZV” and “the chickenpox virus.”

Shingles is also known as herpes zoster. The virus that causes shingles is not the same as the herpes viruses that cause cold sores or genital herpes.

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.

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

Shingles pain can feel different for each person. Some people experience a dull throbbing, while others feel 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 a band on the upper body, but sometimes it appears on the face. Usually, the rash affects only one side of the body.

Additional symptoms of shingles include:

In rare cases, shingles can cause problems with the central nervous system. This can lead to:

Shingles can also lead to serious conditions such as pneumonia. In extremely rare cases, a shingles infection can be fatal.

If a person develops shingles during pregnancy, they should consult a doctor. A person cannot pass shingles to a fetus, as they can with chickenpox. However, the symptoms of shingles may require treatment to avoid potential risks to the pregnant person or the fetus.

Symptoms of shingles on the face

If shingles affects a person’s face, they may experience:

  • a rash
  • a burning sensation, pain, or sensitivity
  • difficulty moving parts of their face
  • hearing loss
  • vertigo
  • drooping eyelids
  • problems with the gums, teeth, tongue, or palate
  • problems with the ability to taste
  • problems with vision, including the inability to move the eye

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

Symptoms of shingles in the eye include:

  • blistering on the forehead, on the tip of the nose, on the upper eyelid, or around the eye, usually on only one side of the face
  • redness and swelling around the eyelid
  • an itchy eye
  • a painful and inflamed cornea (keratitis)
  • sensitivity to light
  • blurred vision
  • difficulty moving the eye (optic nerve palsy)

While these symptoms can indicate shingles, they can also characterize other eye conditions. Anyone with severe eye symptoms should get medical attention right away.

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

When the virus reactivates in a nerve called the trigeminal nerve, it can cause shingles of the eye. The trigeminal nerve carries signals between the brain and several areas of the face, including the eye.

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

To diagnose shingles in the eye, a doctor will perform a physical examination and ask about symptoms. They will usually examine the eye more closely using instruments such as a slit lamp and an ophthalmoscope. This will help them identify clinical signs of the condition both outside and inside the eye.

A doctor may also request tests of:

  • a person’s blood
  • fluid from blisters
  • fluid from the eye

Test results can help determine whether the shingles virus is causing a person’s symptoms.

Treatment options include:

  • Antiviral medications: These drugs can come in liquid or tablet form. A person should take the medication as soon as possible for maximum effectiveness.
  • Eye drops: A person can use these to help keep the eye moist or to treat an infection.
  • Cool compresses: A doctor may recommend placing a cool, slightly damp cloth over the eyes to soothe pain.
  • Pain medications: Treatment options for pain will depend on the severity of pain and other considerations.

If shingles in the eye has caused complications, a person is likely to need additional treatments. In this case, an eye specialist (opthalmologist) will typically determine the best course of treatment.

About 1 in 3 people in the United States will develop shingles at some point in their life.

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

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

  • being older
  • having a lot of stress
  • having another illness
  • having a weakened immune system
  • taking immunosuppressant medications

A vaccine is available that can help prevent people from developing shingles.

Some cases of shingles go away on their own. However, shingles on the face is not something to ignore.

Shingles on the face or in the eye can cause severe complications such as:

The most common complication of shingles is postherpetic neuralgia, which is pain that lasts for a long time after the shingles rash has cleared. The pain can last for months or years. It can sometimes be severe, affecting a person’s daily activities.

Getting shingles treatment early can often prevent or reduce postherpetic neuralgia. Treatments such as antiviral medications can help clear up the infection.

The most effective way to prevent shingles is to get the shingles vaccine.

The Centers for Disease Control and Prevention (CDC) recommend the shingles vaccine (Shingrix) for people who are:

  • aged 50 and older
  • aged 19 and older and have weakened immune systems

The CDC recommend getting two doses of the vaccine.

According to the CDC, 2 doses of Shingrix are 97% effective at preventing shingles in adults aged 50–69 with healthy immune systems.

In adults aged 70 and older with healthy immune systems, 2 doses of Shingrix are 91% effective at preventing the condition.

An older shingles vaccine called Zostavax is no longer available in the United States.

People who are eligible for the shingles vaccine should talk with a doctor to find out whether the vaccine is right for them.

Is shingles contagious?

The same virus causes both shingles and chickenpox. If a person contracts the varicella-zoster virus from someone with shingles, they will develop chickenpox, not shingles.

This means that a person with shingles can spread chickenpox to someone who has never had it. A person with shingles can also spread chickenpox to someone with a weakened immune system. People with weakened immune systems can get chickenpox more than once.

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

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.

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

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

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