A Case of Complete Ophthalmoplegia in Herpes Zoster Ophthalmicus

Hyun-Min Shin, Helen Lew, Young-Su Yun
2005 Korean Journal of Ophthalmology  
Herpes zoster occurs by the reactivation of latent virus lying in the ganglion after a prior attack of chicken pox. 1 Ten to fifteen percent of herpes zoster occurrences involve the ophthalmic branch of the trigeminal nerve, and 50% of these cases involve the ocular component. [2] [3] [4] [5] Complications of herpes zoster ophthalmicus include keratitis, uveitis, secondary glaucoma, cataracts, and the involvement of cranial nerves. 1, 3, 4 The third, fourth, and sixth nerves tend to be
more » ... and the third nerve is the most common site among them. 1,4-6 Ophthalmoplegia associated with herpes zoster ophthalmicus mostly occurs in patients over the age of 50 years. 7 The prognosis of ophthalmoplegia is commonly good. 7 However, complete ophthalmoplegia is reported to be a very rare complication of herpes zoster ophthalmicus. 7, 8 We examined a patient exhibiting complete ophthalmoplegia associated with herpes zoster, and we report on this case with a review of the literature. Purpose: To report a case with complete ophthalmoplegia after herpes zoster ophthalmicus. Methods: A 70-year-old male patient visited a clinic because of vesicular eruptions over the left side of his face with severe pain. Drooping and severe swelling of the left eyelid were present, along with keratitis and uveitis. While the lid swelling and uveitis were improving, external ophthalmoplegia and exophthalmos were discovered. Intramuscular injections of dexamethasone 5 mg were given for 10 days, followed by oral administration of prednisolone at a dosage of 15 mg for two weeks and 10 mg for two weeks. Results: The patient was fully recovered from the complete ophthalmoplegia and exophthalmos six months after the onset of the cutaneous lesion. Conclusions: Complete ophthalmoplegia is a rare ophthalmic complication of herpes zoster infection. Therefore, an evaluation of extraocular muscle and lid function should be performed during the examination of herpes zoster patients in order to screen for ophthalmoplegia.
doi:10.3341/kjo.2005.19.4.302 pmid:16491822 fatcat:lou3stiwunecna6s7wlvs6pnyu