J Korean Ophthalmol Soc.  2007 Nov;48(11):1573-1578.

Herpes Zoster Ophthalmicus Complicated by Hyphema, Glaucoma and External Ophthalmoplegia

• Park SH
• Kim WJ
• Yang SW
• Kim MS

Abstract

PURPOSE: To report a patient with herpes zoster ophthalmicus in whom hyphema, glaucoma and external ophthalmoplegia occurred.
CASE SUMMARY
A 59-year-old male patient developed severe ocular pain and decreased visual acuity in his left eye 10 days ago. He had been diagnosed as herpes zoster ophthalmicus 14 days before and given antiviral agent. He could not percept light. His left eye showed hyphema, severe exudative iritis and elevated IOP. Lid drooping and complete external ophthalmoplegia were present in the left eye. Systemic corticosteroid with concomitant antiviral agents and antiglaucomatous agents was administered.
RESULTS
Light perception did not recover and phthisis bulbi developed in his left eye at 2 months after the onset of the skin lesion. The patient showed gradual improvement in movement of the lid and external ocular muscle.

Keyword

Herpes zoster ophthalmicus; Hyphema; Glaucoma; Ophthalmoplegia; Phthisis bulbi

MeSH Terms

Antiviral Agents
Glaucoma*
Herpes Zoster Ophthalmicus*
Herpes Zoster*
Humans
Hyphema*
Iritis
Male
Middle Aged
Ophthalmoplegia*
Skin
Visual Acuity
Antiviral Agents

Figure

• 

  Figure 1. Photographs of the patient at 14 days after the onset of skin eruption. (Upper left) Left lid drooping and swelling associated with Hutchinson's sign are noted. Crust formation is noted along the distribution of all 3 divisions of the ophthalmic nerve. (Upper right) This photograph showed moderate corneal edema with an epithelial defect, intracameral hemorrhage (gross hyphema, 3.7 mm height) and exudative membrane in his left eye. (Lower) Marked limitation of ocular movement in lateral, medial, superior and inferior gaze is noted in his left eye.

• 

  Figure 2. Photographs of the patient at 4 months after disease onset. (Upper left) The skin lesion turns into scars and lid drooping is somewhat recovered. (Upper right) Left eye shows a hazy and edematous cornea with neovascularization, posterior synechia and iris atrophy. Conjunctival and episcleral vessels are engorged. Left eyeball is soft and perception of light is never recovered. (Lower) Limitation of ocular movement is recovered nearly to normal range.

Reference

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