title: Orbital apex syndrome as a complication of herpes zoster ophthalmicus.
abstract: Orbital apex syndrome is a rare neuro-ophthalmic manifestation of herpes zoster virus infection. We report one such case with favourable outcome in an immunocompetent patient. A 60-year-old woman presented with rash in the dermatome of the left ophthalmic nerve (V1), followed by sudden loss of vision with complete left-sided external and internal ophthalmoplegia. MRI of brain and orbits with contrast revealed optic perineuritis and myositis without intracranial involvement confirming the diagnosis of orbital apex syndrome. Functional visual recovery was achieved after a course of intravenous and oral steroids under antiviral cover over a follow-up period of 3 months.
authors.affiliation: Department of Paediatric and Neuro-ophthalmology, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Chandrasekharan
authors.affiliation: Department of Paediatric and Neuro-ophthalmology, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Uppal
authors.initials: U
authors.lastname: Gandhi
authors.affiliation: Department of Paediatric and Neuro-ophthalmology, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Akshay
authors.initials: A
authors.lastname: Badakere
authors.affiliation: Centre for Ocular Regeneration, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Virender
authors.identifier: http://orcid.org/0000-0002-8229-4158
authors.initials: V
authors.lastname: Sangwan
mesh_terms: D005260:Female; D006563:Herpes Zoster Ophthalmicus / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D009220:Myositis / Q000000981:diagnostic imaging / Q000821:virology*; D009886:Ophthalmoplegia / Q000821:virology*; D009902:Optic Neuritis / Q000000981:diagnostic imaging / Q000821:virology*; D013577:Syndrome; D014786:Vision Disorders / Q000821:virology*