By David F. Box, M.D.
Shingles is a common disease caused by the chickenpox virus. In the past, primary chickenpox typically occurred during the childhood years. The chickenpox vaccine was developed in 1995 and has been routinely administered to children in developed countries for many years. So, it is currently rare for a healthy child to develop chickenpox after receiving the vaccine. However, as the immunity to chickenpox declines over time, individuals grow susceptible to a secondary infection, which we call shingles. Most commonly, the infection manifests itself as a painful rash occurring on one side of the trunk of the body. The second most common location is on one side of the face and scalp.
If the rash occurs in that second location, it can attack the eye directly, causing permanent visual damage and chronic eye pain. In many cases, the risk of this can be decreased by prompt treatment. At the Indiana Eye Clinic, all of our doctors are thoroughly trained in the emergency management of shingles involving the eye structures. We work closely with your primary care physician to optimize your treatment and minimize the risks of chronic complications.
Prior to the development of the chickenpox vaccine, the lifetime risk of developing shingles was between 10-20 percent in individuals who had suffered from chickenpox earlier in life. Most experts believe that the immunity to chickenpox resulting from the childhood vaccine is not as long-lasting as the immunity from an actual case of chickenpox. Therefore, the incidence of shingles is expected to increase in the future among individuals who were born after the early ’90s. In addition, it is expected that shingles in this group of patients may occur at a younger average age than their predecessors. Not all experts agree on this subject but the shingles vaccine is expected to be recommended for these individuals by the time they reach the age of 50.
If you were born before 1990, you still are faced with a 10-20 percent risk of contracting shingles. Usually the disease would appear after age 60 in your group. Ophthalmologists commonly see patients over age 60 who are suffering from shingles occurring on the face and scalp. In most patients, the disease is self-limiting and resolves without long-term complications in 2-3 weeks. Unfortunately there is a small group of shingles patients who suffer long-term complications of this disease.
The best option for this disease is prevention. The shingles vaccine (Zostavax) has been shown to greatly decrease the risk of shingles. The vaccine is approved by the Food and Drug Administration for adults 50 and older. It is currently recommended for adults 60 and older with normal immune systems and no known allergies to the components of the vaccine.