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[Ophthalmoplegia interna after varicella]
P G Schlegel1, J von Wahlert, J Wissert
1Stanford University Medical Center.
Summary
Internal ophthalmoplegia, a rare complication of chickenpox, affected a young girl's right eye pupil, causing dilation and fixation. This condition, though uncommon, highlights potential neurological impacts of the viral illness.
Area of Science:
- Ophthalmology
- Pediatrics
- Infectious Diseases
Background:
- Chickenpox (varicella-zoster virus) is a common childhood illness.
- Neurological complications of chickenpox are infrequent but can be severe.
- Ophthalmoplegia involves paralysis or weakness of eye muscles.
Observation:
- A 5 1/2-year-old girl developed a dilated and fixed right pupil 14 days post-chickenpox rash.
- Initial examination revealed no iridocyclitis or fundus abnormalities.
- Refractive error was recorded as OD +1.0 dpt.
Findings:
- Persistent right pupil dilation and fixation were noted one year later.
- Slight improvement in accommodation was observed (+0.5 dpt).
- This case represents the 14th reported instance of internal ophthalmoplegia complicating chickenpox.
Implications:
- This case underscores the potential for rare ocular motor nerve palsies following varicella infection.
- Early recognition and monitoring are crucial for managing such post-infectious neurological sequelae.
- Further research may elucidate the precise mechanisms linking VZV infection to cranial nerve dysfunction.