I was recently invited to speak to ophthalmologists in the South East of England on a subject I care about passionately, namely shingles of the eye. This can cause devastating loss of vision in some unlucky patients. Perhaps the only good thing about it is that only one eye is ever affected. Unfortunately, the condition gets lumped together with shingles of the skin, which is bad enough as it can result in an extremely painful neuralgia persisting many months after the rash has disappeared. Shingles of the eye, however, can not only cause blindness but chronic redness, scarring and distortion of the eyelids and require patients to take multiple drops and to regularly attend eye outpatients long term. I hasten to add that this only occurs in relatively few patients with eye shingles, but a few is still too many when we do have a means of preventing it!

This can be done by vaccination. As usual, although routinely prescribed in the USA in patients over 50, the vaccination is deemed too expensive for UK patients, so we will have to wait until it’s price comes down before GP’s can prescribe it. Doctors and probably teachers too, come into contact with shingles and chickenpox regularly, so their immunity levels to the (chickenpox) virus keep on getting boosted. The risk of shingles progressively increases with age as your natural immunity declines. Ideally, all patients over the age of 50 would get a series of 2 injections with Zostavax. Trials have shown that this decreases the risk of zoster of the eye by 50%. This may sound disappointing but the important thing is that the trials also showed that the severity of the eye condition in patients who still got ocular shingles was dramatically reduced.

On 8 January 2010, the Joint Committee on Vaccination and Immunisation recommended the vaccine to those aged 70 to 79 but said that that more work needed to be done to make sure that the vaccine could be bought cost-effectively.

Click here for more information on shingles of the eye (Herpes Zoster Ophthalmicus).