Orbital apex syndrome secondary to herpes zoster ophthalmicus

Two women, one with Hodgkin's disease and the other with no malignancy, developed herpes zoster with optic neuropathy and total ophthalmoplegia. Both patients developed an associated mild meningoencephalitis with a predominantly lymphocytic spinal fluid reaction that cleared spontaneously. The patient with Hodgkin's disease suffered a protracted course of the disease and developed a secondary bacterial endophthalmitis that necessitated an envisceration of the left eye. The patient without evidence of immunologic deficit recovered quickly with administration of corticosteroids.