As a result of complications from Ocular Shingles I have recently had two cornea transplants in my left eye. While my recovery from the second graft is coming along well (vision 20/25 two months after second graft with no sign of rejection) and my PHN is under control, I am still very concerned about the herpes zoster virus itself because of all of the nerve and cellular damage it has caused to my cornea thus far. Do I need to always be worried about the virus "re-activating" and causing all of this damage again? I am having a difficult time finding a doctor who can give me solid information and advice regarding my long term prognosis. The eye docs are great with dealing with the cornea but there does not seem to be a doc who can help me with understanding, curing or at least managing the virus long term. Do you have any information or suggestions regarding where I should turn for more assistance with my long term management of the herpes zoster virus? I am a 40 year old professional woman who is not in any way immune compromised (I have had everything tested).
The data as to whether or not stress / fatigue can trigger an HZO reactivation are conflicting. Basically the big studies say "no" and I have plenty of patients who say "yes". So lifestyle stress management, good diet, good sleep, all the usual. Although the studies also say that sunlight isn't a trigger, I believe it is in some people. Sunblock, sunglasses, big hat. You could consider long-term suppression with a low-dose antiviral like acyclovir or famciclovir. Your doctors are staying vague because the likelihood of reactivation is not all that meaningful for one particular patient. Suppose it is 50%. Doesn't sound great, doesn't sound bad. But if YOU reactivate, it is 100% "for you". The fact that you needed a transplant at age 40 suggests that you have a "mean" virus and that your immune system isn't programed to handle it. This doesn't mean you are immune suppressed, just that your particular infection-fighting genome doesn't code for "kill herpes" very well.
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