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Hello and thanks for your question. Are you available to chat?
Your son absolutely needs to see an ophthalmologist. The virus that causes shingles (herpes zoster virus) can most definitely affect the eye and it sounds like it already has. At the very least the virus is causing a dermatitis, but with the way his eyelids are involved, it is likely involving the eyeball itself, as well.
The oral antivirals are going to help as well as the steroids and antibiotics for secondary infection, but he may need medicine that gets put in the eye.
The virus can affect every layer of the eye and in some cases can cause permanent vision loss.
Will tomorrow be soon enough, or does he need emergency treatment?
No, I think tomorrow should be fine. If his eye is bothering him in the meantime, he can use cool compresses over the eye, and artificial tears and/or lubricating eye ointment (both of which he can buy OTC at his local pharmacy) to get some symptomatic relief.
Any idea how long symptoms may last, or what to look for as far as possible worstening?
The skin symptoms will usually get better and resolve over 1-2 weeks time. As far as his eyeball, it really depends on what, if any inflammation is occuring to know how long he may have problems there; so that part will just have to be a wait and see and answered by the ophthalmologist who examines him But as far as worsening goes, if the vision starts to deteriorate, the eye is red and/or painful or there is discharge coming from the eye, these are signs of possible worsening.
Thank you. Do you have any further advice?
Just this: this herpes zoster virus has been lying dormant (latent) in the nerves that supply sensation to his eye and face and they have now reactivated. There is potential for it to reactivate over and over throughout his life, so if/when he has any problems with that eye in the future (once this episode has calmed down), he needs to see his ophthalmologist to make sure that, if it is caused by the herpes zoster virus, it gets treated appropriately and timely. He can no longer do what is very common to many people that are young, which is to assume it will just blow over. He can have serious problems with this eye in the future if he's not careful.
You're welcome. Do you have any further questions about this topic that I can help you with?
Can you tell me what to look for as far as his hearing and facial muscles? As I have stated they are paramount to his career.
Facial muscles generally don't seem to get involved in this; as far as hearing, I believe it is possible that his hearing could be affected, but if it isn't now, I suspect it is unlikely to get involved at this point. However, I am not an ENT doctor, so unfortunately I don't think you can take that advice to the bank, but take it with a grain of salt.
OK. Thanks, ***** *****
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