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36. Orbital Apex Syndrome in Herpes Zoster Ophthalmicus

Author

Arda, Hatice, Mirza, Ertugrul, Gumus, Koray, Oner, Ayse, Karakucuk, Sarper, and Sırakaya, Ender

Subjects
genetic structures, Article Subject, sense organs, eye diseases
Abstract

Orbital apex syndrome is a rare manifestation of Herpes Zoster Ophthalmicus. Herein we report on a case of orbital apex syndrome secondary to Herpes Zoster Ophthalmicus. A 75 year-old male complained of vision loss, conjunctival hyperemia and proptosis on the left eye, was referred to our clinic. Visual acuity was 5/10 Snellen lines and he had conjunctival hyperemia, chemosis, minimal nuclear cataract and proptosis on the left eye. A diagnosis of orbital pseudotumor was demonstrated firstly. The patient received oral and topical corticosteroids, antiinflammatory and antibiotic agents. On day 2, vesiculopustular lesions were observed, Herpes Zoster Ophthalmicus was diagnosed and corticosteroid treatment stopped, oral acyclovir treatment initiated. Two days later, total ophthalmoplegia, ptosis and significant visual loss were observed on the left. The diagnosis of orbital apex syndrome was considered and the patient commenced on an intravenous acyclovir treatment. After the improvement of acute symptoms, a tapering dose of oral cortisone treatment initiated to accelarate the recovery of ophthalmoplegia. At 5-month follow-up, ptosis and ocular motility showed improvement. VA did not significantly improve because of cataract and choroidal detachment on the left. We conclude that ophthalmoplegia secondary to Herpes Zoster Ophthalmicus responds favourably to intravenous acyclovir and steroids.

Published
2012
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38. The role of inflammation and antiinflammation therapies in keratoconjunctivitis sicca

Author

Gumus,Koray, Cavanagh,Harrison Dwight, Gumus,Koray, and Cavanagh,Harrison Dwight

Abstract

Koray Gumus1, Dwight H Cavanagh21Department of Ophthalmology, Erciyes University School of Medicine, Kayseri, Turkey; 2Department of Ophthalmology, The University of Texas Southwestern Medical Center, Dallas, Texas, USAPurpose: To review and integrate recent advances in identifying the role of inflammation in the pathogenesis of dry eye conditions and the biological rationale and practical clinical aspects of newer, antiinflammatory theories.Methods: A comprehensive literature survey. Results and conclusion: Keratoconjunctivitis Sicca (KCS) is a multifactorial and complex disorder in which ocular surface infl ammations play a central role. Identification of specific CD4-T-Cell pathways and the recent recognition of targeting of alpha-fodrin suggest a case for novel new therapeutic aspects such as anti-CD4 monoclonal antibodies, systemic linoleic and gamma-linolenic acids, and omega-6 essential fatty acids. Replacement of tear volume with nonpreserved wetting agents and standard typical antiinflammatory corticosteroid and/or cyclosporine A continues to be central current conventional therapy for KCS.Keywords: dry eye, keratoconjunctivitis sicca, antiinflammatory therapy

Published
2008

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