A Case of Multiple Complications in Herpes Zoster Ophthalmicus

ABSTRACT

PURPOSE: We report a case of stromal keratitis, corneal infiltration, anterior uveitis, central retinal artery occlusion and optic neuropathy in a patient with herpes zoster ophthalmicus. CASE SUMMARY: A 73-year-old man who was hospitalized for pain and vesicles on his left face was referred to our clinic with sudden onset visual disturbance in his left eye. His best corrected visual acuity in the right eye was 0.8 and light-perception in his left eye. Relative afferent pupillary defect was found in his left eye. Slit-lamp examination showed anterior uveitis secondary to herpes zoster ophthalmicus presented with stromal keratitis. Fundus examination showed retinal hemorrhage, vitreous opacity, cherry-red spot in the fovea and optic disc swelling. Delayed arterial filling and arteriovenous transit time were observed on fluorescence angiography. He was treated with topical antiviral and steroid eye drops for stromal keratitis and anterior uveitis. He was also treated systemically with an intravenous antiviral agent and oral steroid, but visual acuity did not improve. CONCLUSIONS: Stromal keratitis, corneal opacity, anterior uveitis, central retinal artery occlusion and optic neuropathy can be complications of herpes zoster ophthalmicus.