Should the ophthalmic branch of the fifth cranial or trigeminal nerve be involved, this can effect the eye. Blisters may form on the cornea, the clear window over the eye, and lead to ulcers and scarring. The inflammation may lead to loss of sensation on the cornea, predisposing it to injury. To protect the cornea it is sometimes necessary to sew the eyelids partially together.
At other times another portion of the nervous system, the geniculate ganglion, is involved and the blisters appear on the ear. This can be associated with vertigo or giddiness and may cause damage to the facial nerve and paralysis of the facial muscles.
The pain is usually superficial and burning in character. The skin in the region of the rash is often so sensitive that even the pressure of the clothes may be painful.
The treatment of shingles has never been satisfactory. Many different treatments have been tried, but few have stood the test of time.
In the initial stages, and later, the pain must be relieved. This can be done with the normally available pain relieving drugs.
Zinc oxide powder dusted on the lesions may relieve the local irritation, keep it dry and help prevent infection.
Cortisone is used in a short course, particularly in the middle-aged and the elderly. It has no effect on the acute illness but does seem to reduce the risk of developing the persistent neuralgic pain which may be so distressing.
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