Unique presentation of 3rd and 6th cranial nerve palsies, nodular scleritis and nummular keratouveitis in an immunocompetent patient following an attack of herpes zoster ophthalmicus.
OBJECTIVE
To report a unique presentation of 3rd and 6th cranial nerve palsies with nodular scleritis and nummular keratouveitis following an attack of herpes zoster ophthalmicus (HZO).


METHODS
Case report.


RESULTS
A 56-year-old woman with a 1-month history of HZO presented with drooping of the right upper eyelid, diplopia, and pain around the right eye. She was noted to have right 3rd and 6th cranial nerve palsies. She developed nodular scleritis and nummular keratouveitis at 2 and 4 months follow-up, respectively, which were treated with antivirals and steroids. At 10 months follow-up, although the diplopia in right lateral gaze persisted, there was no recurrence of ocular inflammation with complete recovery of ptosis.


CONCLUSIONS
A unique presentation of multiple cranial nerve palsies with nodular scleritis and nummular keratouveitis in an immunocompetent patient following an attack of HZO is highlighted in this report.
Kalpana
K
Babu
Raghuvir
R
Kini
Krishna R
KR
Murthy
D015075:2-Aminopurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D020434:Abducens Nerve Diseases / Q000188:drug therapy / Q000821:virology*; D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D004172:Diplopia / Q000188:drug therapy / Q000821:virology; D004359:Drug Therapy, Combination; D000077595:Famciclovir; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006563:Herpes Zoster Ophthalmicus / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000188:drug therapy / Q000821:virology*; D011239:Prednisolone / Q000627:therapeutic use; D015423:Scleritis / Q000821:virology*; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy / Q000821:virology*
D000998:Antiviral Agents; D005938:Glucocorticoids; D015075:2-Aminopurine; D011239:Prednisolone; D000077595:Famciclovir; D000212:Acyclovir