title: An unusual presentation of herpes zoster ophthalmicus: orbital myositis preceding vesicular eruption.
abstract: OBJECTIVE
  To present a case of orbital myositis associated with herpes zoster ophthalmicus.
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  A 47-year-old woman with acute retrobulbar eye pain and diplopia preceding the vesicular rash of herpes zoster ophthalmicus was evaluated and treated.
  
  
  RESULTS
  Magnetic resonance imaging showed enlargement and enhancement of extraocular muscles consistent with an inflammatory myopathy. Following acyclovir and prednisone treatment, all symptoms resolved, and neuralgia did not develop.
  
  
  CONCLUSIONS
  Herpes zoster may cause symptoms and signs of orbital myositis before eruption of cutaneous skin lesions and thus should be considered in the differential diagnosis of an acute orbital myositis.
authors.affiliation: Department of Neuro-ophthalmology, Hôpital Ophthalmique Jules Gonin, Lausanne, Switzerland. aki-kawasaki@ophthal.vd.ch
authors.forename: Aki
authors.initials: A
authors.lastname: Kawasaki
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Borruat
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D004172:Diplopia / Q000175:diagnosis; D004359:Drug Therapy, Combination; D005260:Female; D006563:Herpes Zoster Ophthalmicus / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000473:pathology*; D016727:Orbital Pseudotumor / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010146:Pain / Q000150:complications; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D011241:Prednisone; D000212:Acyclovir