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Eye pain and Herpes Zoster or shingles

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Dear Dr.
I have suffered with severe migraines and occipital neuralgia the past seven years. The pain of both crushes me most days of the week. On the days off it seems my head has decided to play more tricks on me and create more pain. I now have a new headache all the time. My right eye feels like there is burning pressure applied to it at all times. I'm not getting any answers from doctors. "it's just the migraine changing forms." I don't buy it. Can you please help? What is this and how do I treat this? Thank you for your time.
Kindest Regards,

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replied May 24th, 2010
General Q and A Answer A12369

The symptom you reported (severe burning pain in the right eye) might be related to migraine. And yes, it might be the migraine changing forms.
However, there is one condition that might cause the same symptom. Herpes zoster, or more commonly known as shingles, is a viral disease caused by the Varicella Zoster virus. The initial infection with the virus is usually during childhood. Once this initial infection is resolved, the virus stays dormant in the body. If the immune system weakens for any reason, then the virus might start multiplying again, thus causing Herpes Zoster.

One of the most characteristic symptoms of Herpes zoster is pain. Very soon after the pain starts, blisters appear. The blisters contain fluid with viral particles. That is why these blisters are supposed to be kept intact. Otherwise, the infection might be transmitted. Because the virus is actually neurotropic (affecting the nerves), it might also affect one of the nerves responsible for the skin around the eye. The affected nerve would produce a perception of pain in the eye. The blisters might appear in the area, but they might be late for a period of time, thus making the diagnostic procedure more difficult.

You might want to visit an ophthalmologist for an eye examination. Blood laboratory tests might show the viral infection. If Herpes zoster is detected, then adequate antiviral drugs would be recommended.

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