Herpes Zoster Ophthalmicus
Herpes zoster ophthalmicus, also known as ocular shingles, is an infection caused by the varicella-zoster virus (VZV), the same virus responsible for chickenpox. The virus can remain dormant in the body for many years after an outbreak of chickenpox and may reactivate at another point in time. Commonly resulting in rashes on the body, shingles can also affect the eyes.
When the virus reactivates, it usually travels through nerve fibers to infect other parts of the body. The virus may travel to the upper part of the body, affecting the head and the neck. Almost 50 percent of those affected with shingles, in the head and neck area, have corneas that are infected with the virus.
Ocular shingles can occur in anyone exposed to the varicella-zoster virus but people with weakened immune systems or over 80 years of age and older have an increased risk of developing the illness. Ocular shingles is not contagious to others who have had chickenpox or have received the chickenpox vaccine.
Symptoms of Ocular Shingles
Ocular shingles often produces extreme pain on one side of the face, a rash or redness developing in the eye region or on the forehead, eye redness, inflammation of the eye and vision problems. If left untreated, ocular shingles can lead to the following:
- Corneal infection
- Corneal scarring
- Significant vision loss
Treatment of Ocular Shingles
Ocular shingles of the eye is often treated with antiviral eye drops or oral medication, depending on the area of the eye that is affected. If the medication is not administered within the first few days of the appearance of symptoms, it may not be effective. In some cases, steroid eye drops may be prescribed to relieve swelling. An ophthalmologist or cornea specialist should be consulted in order to manage this condition.
Retinal Vein Occlusion
The circulation of blood and nutrients to and from the surface of the retina is achieved with one vein and one artery. If either one of these passages or any of the smaller blood vessels connected to them become blocked, the blood flow to the retina could stop, resulting in a sudden loss of vision.
Retinal vein occlusion, also known as venous stasis retinopathy or hemorrhagic retinopathy, can also lead to:
- Growth of abnormal blood vessels
- Partial or total loss of vision
Retinal vein occlusions are the second most common cause of blood vessel-related vision loss, the first being diabetic retinopathy. A retinal vein occlusion typically occurs in men and women over the age of 50, particularly those in their 60s and 70s.
Risk Factors for a Retinal Vein Occlusion
Risk factors for a retinal vein occlusions include:
- High blood pressure
- High cholesterol
- Vitreous hemorrhage
- Macular edema
- Inflammatory conditions
Treatment of a Retinal Vein Occlusion
There is no cure for a retinal vein occlusion. Emphasis is placed on prevention of the condition by treating the symptoms and preventing further vision loss. A retinal vein occlusion is an indication of vascular disease. It is critical to reduce the risks of vascular disease by adhering to the following guidelines:
- High blood pressure
- High cholesterol
- Stop smoking
- Eat a diet low in fat
- Maintaining weight
- Exercising regularly
Complications of a Retinal Vein Occlusion
Complications of a retinal vein occlusion occur and require treatment that may include:
- Focal laser treatment for macular edema
- Intraocular injections of an anti-vascular endothelial growth factor, or anti-VEGF, to block the growth of blood vessels that can cause glaucoma.
- Laser treatment to prevent the growth of blood vessels that can cause glaucoma
Pseudotumor cerebri is a condition that causes increased pressure inside the skull, resulting in symptoms that are similar to those of a brain tumor. It is often caused by a build-up of cerebrospinal fluid within the brain and occurs more often in women than men. Certain medications, underlying medical conditions or obesity, may all cause increased intracranial pressure, resulting in pseudotumor cerebri. When no underlying cause for this condition can be determined, it may also be referred to as idiopathic intracranial hypertension.
Symptoms of Pseudotumor Cerebri
Increased intracranial pressure within the brain can cause swelling of the optic nerves and vision problems. Additional symptoms of pseudotumor cerebri may include:
- Nausea and vomiting
- Ringing in the ears (tinnitus)
- Blurred vision
- Double vision
- Vision loss
- Neck and shoulder pain
If pseudotumor cerebri is suspected, eye exams, visual field tests, and MRI and CT scans may be performed to confirm a diagnosis. A lumbar puncture (spinal tap) may also be administered to measure glucose and protein levels and intracranial pressure.
Treatment of Pseudotumor Cerebri
The focus of treatment is to improve symptoms and preserve the patient's vision. If pseudotumor cerebri is caused by obesity, weight loss may be recommended. Symptoms may also be treated with:
- Glaucoma medication
- Migraine medication
In severe cases, surgery may be performed to relieve pressure from the optic nerve or a shunt may be inserted into the brain to drain excess cerebrospinal fluid.
The cornea is the clear covering of the front of the eye which bends, or refracts, light rays as they enter the eye. Injuries, such as scratches or cuts, on the surface of the cornea are known as corneal abrasions. Due to the amount of nerve cells in the cornea, a corneal abrasion is usually painful. The pain a patient experiences with a corneal abrasion lets them know that it is a serious condition that needs to be addressed immediately.
Causes of a Corneal Abrasion
A corneal abrasion is a scrape or scratch on the clear front surface of the eye that can occur as a result of the following:
- Exposure to a foreign object
- Ultraviolet light
- Contact lenses that fit improperly
- Sports injury
- A violent rubbing the eyes
- Bacterial infection
- Surgical injury
- Chemical irritation
- Dry eyes
Symptoms of a Corneal Abrasion
Patients with a corneal abrasion may experience some of the following symptoms:
- A sensation of having something in the eye
- Tearing of the eyes
- Red eyes
- Blurry vision
- Sensitivity to bright light
Patients with a corneal abrasion may be unaware that they have the condtion until symptoms begin.
Diagnosis of a Corneal Abrasion
Patients exhibiting symptoms of a corneal abrasion should be seen by the ophthalmologist. During the examination of the eyes some of the following tests may be conducted:
- Fluorescein eye stain
- Examination of the eye
Treatment of a Corneal Abrasion
Depending on the cause of the condition, a corneal abrasion may be treated with a combination of the following methods:
- Rinsing the eye
- Using artificial tears
- Over-the-counter medication
- Antibiotic eye drops
- Antibiotic ointment
Pain medication or eye drops to reduce muscle spasms may be prescribed. It is important for patients with a corneal abrasion to avoid touching or rubbing their eyes. In most cases, a corneal abrasion can be effectively treated with no permanent complications and typically heals within a matter of days. Depending on the severity of the corneal abrasion, a corneal transplantation may be recommended.
Prevention of a Corneal Abrasion
Corneal abrasions may be prevented with the following methods:
- Using protective eyewear
- Wearing sunglasses
- Properly using household cleaning supplies