Orbital Apex Syndrome Caused by Herpes Zoster Ophthalmicus Following Nasal Endoscopic Surgery: A Case Report

Orbital apex syndrome (OAS) is a severe orbital condition caused by impairment of cranial nerves after inflammation or local compression. The report details an uncommon case of OAS caused by herpes zoster ophthalmicus (HZO) following endoscopic sinus surgery. A 52-year-old male exhibited symptoms of OAS in the postoperative phase; however, imaging examination and endoscopic evaluations failed to support that surgical damage and bacterial infection were the cause. The distinctive skin manifestations of herpes zoster around eye were the important clue for diagnosis. The patient was diagnosed with OAS caused by HZO and recovered after antiviral treatment for two weeks. During a one-month follow-up, the patient reported no eye-related sequelae. This case highlights the significance of early diagnosis and prompt intervention to achieve optimal clinical outcomes.