title: Isolated, complete paralytic mydriasis secondary to herpes zoster ophthalmicus.
abstract: Herpes zoster ophthalmicus is a manifestation of herpes zoster when the ophthalmic division of the trigeminal nerve becomes involved. Ocular symptoms are varied and mainly due to inflammatory mechanisms. Total, external and/or internal ophthalmoplegias, as well as isolated third, fourth and sixth cranial nerve palsies have all been reported as complications. In a minority of cases, concurrent pupillary paralysis has been documented. The presentation of complete paralytic mydriasis as the sole cranial nerve complication following herpes zoster ophthalmicus infection is a rare finding. The postulated pathophysiologic aetiology is a partial third nerve palsy with the pupillary fibres for light and accommodation-convergence affected and motor fibres spared. The mechanism responsible for the postulated lesion is speculative.
authors.affiliation: Division of Ophthalmology, Section Oculofacial Plastic and Reconstructive Surgery, Ohio University/OhioHealth Doctor's Hospital, Columbus, Ohio 43201, USA. dsp4000@aol.com
authors.forename: Craig N
authors.initials: CN
authors.lastname: Czyz
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Bacon
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Petrie
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Justice
authors.forename: Kenneth V
authors.initials: KV
authors.lastname: Cahill
mesh_terms: D000368:Aged; D005260:Female; D006563:Herpes Zoster Ophthalmicus / Q000150:complications*; D006801:Humans; D015878:Mydriasis / Q000175:diagnosis / Q000209:etiology / Q000821:virology; D014792:Visual Acuity
keywords: HERPES ZOSTER; OPHTHALMOLOGY; PUPILS