Management of Herpes Zoster Ophthalmicus with Optic Neuritis and Cavernous Sinus Involvement: A Case Report.

PURPOSE: To report a treatment approach of a rare presentation of herpes zoster ophthalmicus (HZO) with optic neuropathy and oculomotor nerve palsy.

METHODS

Report of one case.

RESULTS

Multiple lesions involving the optic nerve and cavernous sinus were demonstrated on magnetic resonance imaging in a patient with a characteristic herpes zoster rash in the V1 dermatomal distribution. Following treatment with systemic ganciclovir and intravenous corticosteroids, the patient experienced dramatic improvement in visual acuity, from hand motion to 20/25.

CONCLUSION

This report demonstrates a rare case of HZO optic neuropathy with cavernous sinus involvement that was successfully treated with an unconventional medication regimen.