From the Guidelines
Chickenpox can cause periorbital edema, although it is not a common symptom, and the swelling typically resolves as the infection clears. When chickenpox affects the face, the virus can cause swelling around the eyes due to inflammation from nearby blisters or as part of the body's immune response to the infection 1. According to the conjunctivitis preferred practice pattern, varicella-zoster virus (VZV) conjunctivitis can present with bulbar conjunctival injection, watery discharge, and mild follicular reaction of conjunctiva, which may be associated with periorbital edema 1.
Key Points to Consider
- The varicella-zoster virus can affect various body systems, including tissues around the eyes, leading to symptoms like periorbital edema 1.
- If severe eye swelling, pain, vision changes, or red and crusty eyes occur during chickenpox, medical attention should be sought promptly to rule out complications like conjunctivitis or more serious eye involvement 1.
- To manage mild eye puffiness during chickenpox, it is recommended to keep the area clean, avoid touching or scratching blisters near the eyes, use cool compresses for comfort, and take acetaminophen (Tylenol) as directed for discomfort 1.
- Antihistamines may help reduce itching and swelling associated with periorbital edema during chickenpox 1.
Important Considerations for Treatment
- Topical antibiotics may be used to prevent secondary infection in patients with VZV conjunctivitis 1.
- Topical antivirals alone have not been shown to be helpful in treating VZV conjunctivitis but may be used as additive treatment in unresponsive patients 1.
- Oral antivirals may be beneficial in persistent or recalcitrant acute/subacute disease in immunocompetent patients 1.
From the Research
Ocular Manifestations of Varicella
- Varicella, also known as chickenpox, can cause various ocular complications, including conjunctival lesions, corneal lesions, iridocyclitis, glaucoma, chorioretinitis, and optic nerve lesions 2
- However, there is no direct evidence in the provided studies that varicella causes periorbital edema (puffy eyes)
Specific Ocular Complications
- Acute anterior uveitis, stromal keratitis, and acute retinal necrosis have been reported as ocular complications of varicella in adults 3
- Stromal keratitis has been reported as a potential manifestation after chickenpox in children, with a chronic course lasting 3 months or more 4
- Optic neuritis has been reported as a rare complication of varicella infection in an immunocompetent child 5
- Discrete conjunctival lesions have been reported as a complication of primary varicella zoster virus infection 6