Ophthalmoplegia secondary to herpes zoster ophthalmicus.
An 80-year-old Caucasian woman had been diagnosed with right herpes zoster ophthalmicus 2 &frac12; weeks before presentation to our department. Ten days after stopping oral aciclovir, she presented with periorbital pain, visual loss, ptosis and complete ophthalmoplegia. On examination, visual acuity in her right eye was hand movements, with a relative afferent pupillary defect and 2 mm proptosis. MRI demonstrated contrast enhancement within the orbit extending into the apex, suggestive of an inflammatory process. Oral treatment was started with oral aciclovir and corticosteroids for 2 months, when she had resolution of the optic neuropathy and ophthalmoplegia. Vision recovered to 6/9 and repeat neuroimaging revealed regression of the inflammatory process.
Manchester Academic Health Sciences Centre and NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK. marta_ugarte@yahoo.es
Marta
M
Ugarte
Sarju
S
Dey
Carole A
CA
Jones
D000212:Acyclovir / Q000627:therapeutic use; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006563:Herpes Zoster Ophthalmicus / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology* / Q000821:virology
D000998:Antiviral Agents; D000212:Acyclovir