Herpes zoster (HZ) virus is a neurotropic virus that frequently involves the ophthalmic division of the trigeminal nerve. The common clinical findings in HZ ophthalmicus are well recognized and include vesicular lesions and edema of the eyelid and periorbital skin, keratoconjunctivitis, scleritis, and uveitis. Ophthalmoplegia frequently occurs with HZ virus infection, and HZ virus-induced orbital myositis has been considered a possible pathogenetic mechanism.1 However, well-documented cases illustrating this association are lacking.2 Proptosis secondary to HZ virus-induced orbital inflammation has been reported; however, these cases occurred in the era before computed tomography.3 We report a case of orbital myositis in a patient who developed HZ ophthalmicus 1 day after the onset of orbital symptoms.
Report of a Case.
—A 45-year-old white man presented to the emergency department with a 2-day history of sharp pains behind the left eye, swelling and burning around the left eye, intermittent binocular double
Volpe NJ, Shore JW. Orbital Myositis Associated With Herpes Zoster. Arch Ophthalmol. 1991;109(4):471-472. doi:10.1001/archopht.1991.01080040039015