Isolated Internal Ophthalmoplegia following Herpes Zoster Ophthalmicus

Herpes zoster ophthalmicus (HZO) is a disease involving the ophthalmic division of the trigeminal nerve due to the reactivation of the latent varicella-zoster virus in the dorsal root ganglion, commonly affecting people with compromised immunity and advancing age. It can cause a myriad of ocular man...

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Main Authors: Neha Pathak, Gagan Deep Kaur, Virendra Agrawal, Amit Mishra
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Delhi Journal of Ophthalmology
Subjects:
Online Access:https://journals.lww.com/10.4103/DLJO.DLJO_164_24
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author Neha Pathak
Gagan Deep Kaur
Virendra Agrawal
Amit Mishra
author_facet Neha Pathak
Gagan Deep Kaur
Virendra Agrawal
Amit Mishra
author_sort Neha Pathak
collection DOAJ
description Herpes zoster ophthalmicus (HZO) is a disease involving the ophthalmic division of the trigeminal nerve due to the reactivation of the latent varicella-zoster virus in the dorsal root ganglion, commonly affecting people with compromised immunity and advancing age. It can cause a myriad of ocular manifestations. Total external and internal ophthalmoplegia occurs in 10%–30% of cases. Isolated third, fourth, and sixth cranial nerve palsies have also been reported. However, isolated pupillary paralysis as a solitary cranial nerve complication is rare. The suggested etiopathogenesis is acute ganglionic/postganglionic neuron denervation injury. We present one such case showing persistent tonic pupil even at 15 months following the onset of HZO despite the recovery in inflammation with treatment.
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publishDate 2025-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Delhi Journal of Ophthalmology
spelling doaj-art-93764e91a16c4aa2bd0e8bc2ee78fe812025-08-20T02:11:18ZengWolters Kluwer Medknow PublicationsDelhi Journal of Ophthalmology0972-02002454-27842025-01-01351646610.4103/DLJO.DLJO_164_24Isolated Internal Ophthalmoplegia following Herpes Zoster OphthalmicusNeha PathakGagan Deep KaurVirendra AgrawalAmit MishraHerpes zoster ophthalmicus (HZO) is a disease involving the ophthalmic division of the trigeminal nerve due to the reactivation of the latent varicella-zoster virus in the dorsal root ganglion, commonly affecting people with compromised immunity and advancing age. It can cause a myriad of ocular manifestations. Total external and internal ophthalmoplegia occurs in 10%–30% of cases. Isolated third, fourth, and sixth cranial nerve palsies have also been reported. However, isolated pupillary paralysis as a solitary cranial nerve complication is rare. The suggested etiopathogenesis is acute ganglionic/postganglionic neuron denervation injury. We present one such case showing persistent tonic pupil even at 15 months following the onset of HZO despite the recovery in inflammation with treatment.https://journals.lww.com/10.4103/DLJO.DLJO_164_24anisocoriaherpes zoster ophthalmicusinternal ophthalmoplegiapilocarpinetonic pupil
spellingShingle Neha Pathak
Gagan Deep Kaur
Virendra Agrawal
Amit Mishra
Isolated Internal Ophthalmoplegia following Herpes Zoster Ophthalmicus
Delhi Journal of Ophthalmology
anisocoria
herpes zoster ophthalmicus
internal ophthalmoplegia
pilocarpine
tonic pupil
title Isolated Internal Ophthalmoplegia following Herpes Zoster Ophthalmicus
title_full Isolated Internal Ophthalmoplegia following Herpes Zoster Ophthalmicus
title_fullStr Isolated Internal Ophthalmoplegia following Herpes Zoster Ophthalmicus
title_full_unstemmed Isolated Internal Ophthalmoplegia following Herpes Zoster Ophthalmicus
title_short Isolated Internal Ophthalmoplegia following Herpes Zoster Ophthalmicus
title_sort isolated internal ophthalmoplegia following herpes zoster ophthalmicus
topic anisocoria
herpes zoster ophthalmicus
internal ophthalmoplegia
pilocarpine
tonic pupil
url https://journals.lww.com/10.4103/DLJO.DLJO_164_24
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AT gagandeepkaur isolatedinternalophthalmoplegiafollowingherpeszosterophthalmicus
AT virendraagrawal isolatedinternalophthalmoplegiafollowingherpeszosterophthalmicus
AT amitmishra isolatedinternalophthalmoplegiafollowingherpeszosterophthalmicus