Open AccessA rare case of orbital apex syndrome with herpes zoster ophthalmicus in a human immunodeficiency virus-positive patient
Author(s) -
Rohit Saxena,
Swati Phuljhele,
Lalit Aalok,
Ankur Sinha,
Vimla Me,
Pradeep Sharma,
Anant Mohan
Publication year - 2010
Publication title -
indian journal of ophthalmology/indian journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 51
eISSN - 1998-3689
pISSN - 0301-4738
DOI - 10.4103/0301-4738.71708
Subject(s) - medicine , herpes zoster ophthalmicus , visual acuity , ptosis , varicella zoster virus , uveitis , ophthalmology , forehead , dermatology , surgery , virology , virus
We report a rare instance of favorable outcome in orbital apex syndrome secondary to herpes zoster ophthalmicus (HZO) in a human immunodeficiency virus (HIV)-positive patient. The patient complained of pain and decrease in vision in one eye (20/640) for 2 weeks accompanied with swelling, inability to open eye, and rashes around the periocular area and forehead. The presence of complete ophthalmoplegia, ptosis, relative afferent pupillary defect, and anterior uveitis with decreased corneal sensation prompted a diagnosis of HZO with orbital apex syndrome. The enzyme-linked immunosorbent assay test and a low CD4 count confirmed HIV. Highly active antiretroviral therapy (HAART), systemic acyclovir, and systemic steroids were started. Visual acuity and uveitis improved within 10 days. By the end of the fourth week, ocular motility also recovered and the final visual acuity was 20/25. We highlight the role of HAART, used in conjunction with systemic steroid and acyclovir therapy, in improving the outcome.