Severe, permanent orbital disease in herpes zoster ophthalmicus.
A 63-year-old man with HZO presented with involvement of cranial nerves II, III, IV, V, and VI, with proptosis, raised intraocular pressure, and chemosis. With the aid of orbital imaging, a diagnosis of orbital apex inflammation secondary to HZO was confirmed, and he was treated with intravenous acyclovir and oral steroids. Despite this, he made a minimal recovery at eight months following presentation. Severe, irreversible orbital disease may develop following HZO, and an ischemic vasculitis may play a role in the pathogenesis of the disease.
Dhingra
Sumit
S
Eye Department, John Radcliffe Hospital, Oxford, United Kingdom. drsumitdhingra@hotmail.com
Williams
Geraint
G
Pearson
Andrew
A
D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001763:Blepharoptosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D004359:Drug Therapy, Combination; D004487:Edema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005094:Exophthalmos / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use; D006563:Herpes Zoster Ophthalmicus / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007262:Infusions, Intravenous; D007429:Intraocular Pressure; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000998:Antiviral Agents; D005938:Glucocorticoids; D011239:Prednisolone; D000212:Acyclovir