[Complete ophthalmoplegia following outburst of herpes zoster]

Abstract

An 86-year-old female presented with eye pain, complete ophthalmoplegia, a visual acuity of 1/60, vitritis, ptosis, displacement of the eye, and a partially dilated pupil unresponsive to light. A computed tomography of the cerebrum was normal. Herpes zoster ophthalmicus was suspected and treatment with i.v. acyclovir and prednisolone was commenced, which led to a gradual improvement of the clinical condition. Complete ophthalmoplegia due to herpes zoster ophthalmicus is a very rare condition and no evidence-based treatment is available. The prognosis is very good with almost complete remission of the symptoms within 18 months.