Management of Herpes Zoster Ophthalmicus with Optic Neuritis and Cavernous Sinus Involvement: A Case Report

To report a treatment approach of a rare presentation of herpes zoster ophthalmicus (HZO) with optic neuropathy and oculomotor nerve palsy.

Report of one case.

Multiple lesions involving the optic nerve and cavernous sinus were demonstrated on magnetic resonance imaging in a patient with a characteristic herpes zoster rash in the V1 dermatomal distribution. Following treatment with systemic ganciclovir and intravenous corticosteroids, the patient experienced dramatic improvement in visual acuity, from hand motion to 20/25.

This report demonstrates a rare case of HZO optic neuropathy with cavernous sinus involvement that was successfully treated with an unconventional medication regimen.