Korean J Ophthalmol.  2005 Dec;19(4):302-304. 10.3341/kjo.2005.19.4.302.

A Case of Complete Ophthalmoplegia in Herpes Zoster Ophthalmicus

• Shin HM
• Lew H
• Yun YS

• KMID: 754444
• DOI: http://doi.org/10.3341/kjo.2005.19.4.302

Abstract

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.

Keyword

Complete ophthalmoplegia; exopthalmos; herpes zoster ophthalmicus

MeSH Terms

Severity of Illness Index
Prednisolone/therapeutic use
Ophthalmoplegia/drug therapy/*etiology
Male
Humans
Herpes Zoster Ophthalmicus/*complications/drug therapy
Glucocorticoids/therapeutic use
Follow-Up Studies
Exophthalmos/drug therapy/etiology
Aged

Figure

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  Fig. 1 (A) Vesicular eruption over the left side of face. (B) Severe proptosis of left eye.

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  Fig. 2 Nine cardinal directions of ocular movement at an early stage of disease. Left lid drooping and limitation of ocular movement in all nine directions of gaze were noted.

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  Fig. 3 Nine cardinal directions of ocular movement at six months after disease onset. Lid drooping and limitation of ocular movement were recovered to normal, except for adduction.

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