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Dr. JP
Dr. JP, Ophthalmology, Oculoplastic Surgery
Category: Eye
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Experience:  Harvard Medical School, Massachussetts Eye and Ear
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good afternoon, yesterday i woke up with incredible L eye pain,

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good afternoon, yesterday i woke up with incredible L eye pain, constant tearing, and extreme photophobia. went to an urgent care center and was told that i have a possible corneal abrasion/ulceration and was put on Q2 sulfacetamide sodium drops. was told to see an opthamologist if it wasn't improved in 24-48 hours for further evaluation (slit lamp). 2 days ago i had an AIDS patient with varicella zoster in her eyes... is there any way that i have that now and it really is acute retinal necrosis?? my husband remembers me having allergies pretty badly the night before waking up with the eye pain and he said i had been rubbing my eyes a lot... that leads me to believe it is a corneal abrasion, but i just want to know if i'll be able to tell the difference between a corneal abrasion and possible varicella zoster. would i have symptoms that quickly if i was infected, etc?
Submitted: 4 years ago.
Category: Eye
Expert:  Dr. JP replied 4 years ago.

Varicella Zoster VZV is a reactivation of a latent viral infection, chicken pox. Patient who are immunocompromised get this reactivation quite commonly. Otherwise healthy young people do not unless they are immunocompromised, on chronic steroids. Symptoms of zoster, especially herpes zoster ophthalmicus, typically start with a tingling sensation over the forehead, eyebrow on one side. Then over a few day vessicular leison crop up on the skin of the forehead and upper eyelid and stay unilateral and do not cross midline. The eye findings depend on the extent of disease that can be corneal dendrites on the cornea, can have corneal edema and inflamation of the inside of the eye, and the retina can be invovled as you mentioned in an entity known as ARN (acute retinal necrosis). This is usually seen with herpes simples but can be with any of the herpes family. Symptoms would be severe eye pain, significant vision loss, floater due to inflamation of the fluid filled part of the eye called vitreous and on dilated eye exam one would see retinal whitening and necrosis. If you have good vision, eye pain has improved with treatment, your young, healthy it's unlikely you have ARN. Describe your vision and symptoms to me a bit.

 

 

Customer: replied 4 years ago.

thanks for your detailed explanation of herpes zoster opthalmicus. i'm already relieved! my vision is blurry at times, but definitely improving. burning sensation pretty constant, but believe that is primarily from the drops. at times it feels like there is something "loose" in my eye, but the PA that i saw at the urgent care center didn't see anything after he washed out my eyes, stained them and looked through a black light. have to really focus on things in the distance - totally failed the eye chart exam at the urgent care center. i have been wearing an eye patch and don't see floaters but tv "white noise" wiith it on. i'm still tearing up a lot and have to close my eyes. typing this right now is causing major discomfort. if i even touch my eye lid tears form. my eye lids are puffy and my eyes are red. still very sensitive to light - have been in the dark most of the day.

Expert:  Dr. JP replied 4 years ago.

I'm sure you have a corneal epithelial defect that will resolve in 1-2 days. continue with ointment and pain control with ice packs, motrin, tylenol if you tolerate it. it was great talking with you

 

 

Expert:  Dr. JP replied 4 years ago.

if i can help more let me know. if not please hit accept button so i can get paid. also will leave feedback

 

Regards

 

JP

Dr. JP, Ophthalmology, Oculoplastic Surgery
Category: Eye
Satisfied Customers: 28
Experience: Harvard Medical School, Massachussetts Eye and Ear
Dr. JP and other Eye Specialists are ready to help you
Customer: replied 4 years ago.
hey, just one more question about it. i stopped taking the antibiotic drops because it was causing worse blurry vision and extreme burning pain. i've actually been able to take off the patch for minutes at a time and can tolerate the light somewhat. it's been three days now though. should i still go and have it examined by an eye doctor? and do i take the drops even though it causes such severe pain and symptoms? i thought i might be having a sulfa allergy (even though i have never before). thank you!

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