Blog vol 3. 2. My annual tirade on Herpes Zoster (shingles).
I was reminded this week why I go on about this condition, shingles, the reoccurrence of Herpes Zoster or chicken pox, which once in your system stays there.
10% of chicken pox survivors go on to get shingles. It is more common in older people, but also does affect the under-50 crowd. Causes are unclear though anything that compromises the immune system is suspect.
Anecdotally, it does seem to hit people when they are already stressed: a big life change, a nasty diagnosis…
One of my patients came in for her annual visit this week. In 2019, she had a bout of shingles, and as with 25% of people with shingles, it affected her eye. Shingles can start on the eye brow, go down the nose, and get into the cornea of the eye.
After three years and much treatment with steroids to keep inflammation down, she still struggles with the results. She now has a permanent scar at the centre of her cornea that has dropped her vision to 20/80. The end result will be a corneal transplant to replace this damaged tissue.
There is antiviral treatment which if given in the first 72 hours of a bout of Shingles, can help to control the attack, but the neuralgia, pain, often persists long after. As with this patient the virus can cause chronic eye pain and even vision loss.
Shingles can be usually prevented with vaccination.
The chicken pox vaccine is routinely available for children and is part of standard care at this point. For those of us who had chicken pox as children, there is a vaccine, Shingrix, which is able to prevent shingles in 90-97% of people 50 years of age or older, and in 89.1% of 80-year-olds.
Shingrix is given intramuscularly in two doses two to six months apart, and is covered by OHIP, if you are between 65-70 years of age and have not received Zostavax (the original shingles vaccine) from the government. These are the current parameters, which will hopefully change.
Shingrix is available to people outside this age bracket but is costly. If possible, I would highly recommend the expense and trouble.
The doctors and staff here at Burlington Eyecare continue to educate and ensure that all our patients get their zoster shots. I know I can speak for all health practitioners out there, get your vaccine and let’s make this bug history.
Til next week,
the good doctor
