Superior orbital fissure syndrome in herpes zoster ophthalmicus.
OBJECTIVE
To report a case of superior orbital fissure syndrome (SOFS) in a patient with herpes zoster ophthalmicus (HZO).


METHODS
A case report.


RESULTS
A 71-year-old male with HZO presented acutely to accident and emergency complaining of right vision loss, double vision and drowsiness. The right visual acuity was counting fingers. There was no relative afferent pupillary defect. He had interstitial keratitis, ptosis, proptosis and total ophthalmoplaegia. The signs indicated HZO complicated by SOFS. Brain imaging and lumbar puncture confirmed the diagnosis of varicella zoster encephalitis. Systemic acyclovir and prednisolone led to recovery of visual acuity and ocular motility in addition to resolution of his proptosis and ptosis.


CONCLUSIONS
SOFS is a rare complication of herpes zoster infection. With the appropriate treatment and follow-up, patients may be reassured that recovery of their visual acuity and ocular motility will occur.
Kirwan
R P
RP
Department of Ophthalmic Surgery, St Vincent's University Hospital, Dublin 4, Ireland. ruaidhri.kirwan@ucd.ie
Abdalla
M
M
Hogan
A
A
Tubridy
N
N
Barry
P
P
Power
W
W
D000212:Acyclovir / Q000627:therapeutic use; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006563:Herpes Zoster Ophthalmicus / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D009915:Orbit; D009916:Orbital Diseases / Q000175:diagnosis / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D005938:Glucocorticoids; D003907:Dexamethasone; D011239:Prednisolone; D000212:Acyclovir