Herpetic optic neuritis associated with herpetic keratitis.
OBJECTIVE
To report a case of herpetic optic neuritis associated with herpetic keratitis.


METHODS
A 65 year old woman presented with oedema in the nasal sector of his right papilla. Blood biochemistry, a haemogram, erythrocyte sedimentation rate and C-reactive protein were all normal. The patient was diagnosed as having a non-arteritic anterior ischaemic optic neuropathy. One week later slit lamp examination showed diffuse stromal corneal oedema and a dendritic lesion in the nasal zone of the corneal epithelium.


RESULTS
Serology for varicela-zoster virus was positive. Treatment was started with valacyclovir given orally and topical acyclovir ointment. A week later, the optic disc swelling and corneal lesions had resolved.


CONCLUSIONS
The precise mechanism through which the papilla and cornea were successively affected in our patient is unclear but the sensitive innervation of both these structures is provided by the nasal branch of the nasociliary nerve and the spread of herpes via this nerve could affect both sites.
Department of Ophthalmology, Hospital Clinico Universitario San Carlos-Universidad Complutense, 28003 Madrid, Spain. federicosaenzfrancessb@gmail.com
F
F
Sáenz-Francés
C
C
Calvo-González
M
M
Jiménez-Santos
C
C
Méndez-Hernández
A M
AM
Fernandez-Vidal
J M
JM
Martínez-de-la-Casa
J
J
García-Sánchez
J
J
García-Feijoó
D000212:Acyclovir / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000284:Administration, Oral; D000287:Administration, Topical; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006563:Herpes Zoster Ophthalmicus / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D014645:Herpesvirus 3, Human / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D016849:Keratitis, Herpetic / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D009902:Optic Neuritis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D000077483:Valacyclovir; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use
D000914:Antibodies, Viral; D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir