Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2002;66(9):1732

What is HZO?

Herpes zoster ophthalmicus (HZO), commonly known as shingles is caused by the chickenpox virus. It involves the skin around the eye and sometimes the eye itself. It is not the same virus that causes herpes simplex.

What are the symptoms of HZO?

HZO can cause a rash with small blisters to break out on the forehead and around the eye on one side of your face. Sometimes you will have pain in the same area of your face a few days before the outbreak.

Who gets HZO and why? Can I prevent it?

There is nothing you can do to prevent HZO. It is not common in children, but it occurs more often as people get older. Men and women are equally affected. Often people who get HZO have had chickenpox or have been exposed to the chickenpox virus in the past.

How can my doctor tell if I have HZO?

If you have HZO, you will probably have a rash that looks like chickenpox, but only on one side of your face. Besides examining you, your doctor will not need to do any additional tests to see if you have HZO. Sometimes herpes simplex infections can resemble HZO. However, the patterns of the rashes are different and your doctor will be able to tell them apart.

How often is the eye involved?

The eye itself is affected in 10 percent of patients. Your doctor will examine you to see if the eye is involved. If it is, you may need to see an ophthalmologist (a doctor who specializes in treating eyes) for further treatment.

How is HZO treated?

If you think you might have HZO, see your doctor right away. Early treatment with antiviral medicines can reduce pain and the duration of symptoms. Your doctor can give you advice about treatment, but rest is also important. Cool compresses can ease the pain and rash. Pain medicine such as aspirin or acetaminophen (Tylenol) may help.

How long will I have the infection?

If you have pain from HZO, it should get better as the rash goes away. With uncomplicated HZO, you should recover in a few weeks, but it may take longer in older or sicker patients.

Can I infect other people?

If you have HZO, you can give the virus that causes chickenpox to other people. Therefore, you should avoid people who have not had chickenpox (especially pregnant women) and very sick patients (such as patients with cancer or AIDS). If you live with children who have not had chickenpox, you should tell your doctor. They may need to be vaccinated.

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