Herpes Zoster Ophthalmicus with Ophthalmoplegia: A Case Report and Review of Literature
Keywords:
Herpes zoster ophthalmicus, abducens nerve, ophthalmoplegiaAbstract
Herpes zoster ophthalmicus (HZO) is associated with a wide range of ocular complications from the anterior segment to the posterior segment, including neurological complications. Multiple cranial nerve palsies as a sequelae of HZO is less commonly seen. Here we reported a case of herpes zoster ophthalmicus with abducens nerve palsy and pupillary involvement in a young immunocompetent man. A 31-year-old man presented with right eye swelling, redness, blurring of vision for 3 days, associated with vesicles over the right sided forehead and periorbital region, with impaired gaze and diplopia. Diagnosis of right HZO with sixth nerve palsy and partial third nerve palsy was made. He was treated with a course of systemic antiviral therapy and steroids therapy. He has complete resolution of ophthalmolegia after 3 months of treatment.
References
Harding SP, Lipton JR, Wells JC. Natural history of herpes zoster ophthalmicus: predictors of postherpetic neuralgia and ocular involvement. Br J Ophthalmol. 1987;71(5):353-358.
Johnson RW. Herpes zoster and postherpetic neuralgia. Expert review of vaccines. 2010 Mar 1;9(sup3):21-6.
Gupta N, Sachdev R, Sinha R, Titiyal JS, Tandon R. Herpes zoster ophthalmicus: disease spectrum in young adults. Middle East Afr J Ophthalmol. 2011;18(2):178–82
Chan AY, Conrady CD, Ding K, Dvorak JD, Stone DU. Factors associated with age of onset of herpes zoster ophthalmicus. Cornea. 2015 May 1;34(5):535-40.
Liesegang TJ. Herpes zoster ophthalmicus: natural history, risk factors, clinical presentation, and morbidity. Ophthalmology. 2008 Feb 1;115(2):S3-12.
Horton JC. Neurovisual manifestations of herpesviruses. International ophthalmology clinics. 2002 Jan 1;42(1):33-41.
Marsh RJ, Dulley B, Kelly V. External ocular motor palsies in ophthalmic zoster: a review. British Journal of Ophthalmology. 1977 Nov 1;61(11):677-82.
Shin MK, Choi CP, Lee MH. A case of herpes zoster with abducens palsy. Journal of Korean medical science. 2007 Oct 1;22(5):905-7.
Gupta R, Lata H, Narang S, Sood S. Herpes Zoster Ophthalmicus with Abducens Palsy. Asian Journal of Ophthalmology. 2003;5(2).
Sanjay S, Chan EW, Gopal L, Hegde SR, Chang BC. Complete unilateral ophthalmoplegia in herpes zoster ophthalmicus. Journal of Neuro-ophthalmology. 2009 Dec 1;29(4):325-37.
Czyz CN, Bacon TS, Petrie TP, Justice JD, Cahill KV. Isolated, complete paralytic mydriasis secondary to herpes zoster ophthalmicus. Practical neurology. 2013 Jun 1;13(3):183-4.
Casal IA, Monteiro S, Borges T, Vale C, Friande A, Araújo M, Beirão JM. Herpes Zoster Ophthalmicus with Isolated Paralytic Mydriasis. Ann Clin Case Rep. 2016; 1.;1082.
Pavan-Langston D. Herpes zoster: antivirals and pain management. Ophthalmology. 2008 Feb 1;115(2):S13-20.
Downloads
Published
Issue
Section
License
The Thai Journal of Ophthalmology (TJO) is a peer-reviewed, scientific journal published biannually for the Royal College of Ophthalmologists of Thailand. The objectives of the journal is to provide up to date scientific knowledge in the field of ophthalmology, provide ophthalmologists with continuing education, promote cooperation, and sharing of opinion among readers.
The copyright of the published article belongs to the Thai Journal of Ophthalmology. However the content, ideas and the opinions in the article are from the author(s). The editorial board does not have to agree with the authors’ ideas and opinions.
The authors or readers may contact the editorial board via email at admin@rcopt.org.
