Concurrent hyphema and orbital apex syndrome following herpeszoster ophthalmicus in a middle aged lady
INTRODUCTION: Hyphema and orbital apex syndrome occurring concurrently in a patient with herpes zoster ophthalmicus have not been reported previously. We present a case with these unique findings and discuss the pathogenesis of these conditions and their management. PRESENTATION OF CASE: A 59-year-...
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| Format: | Article |
| Language: | English |
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Elsevier
2017
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| Online Access: | http://eprints.usm.my/36837/ http://eprints.usm.my/36837/1/%28Concurrent_hyphema_and_orbital%29_1-s2.0-S221026121630548X-main.pdf |
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| author | Khairuddin, Othman Li Min, Evelyn-Tai Mohd Noor, Raja-Azmi Muhammed, Julieana Ahmad Tajudin, Liza-Sharmini John, Tharakan Alwi, Muhd Besari Embong, Zunaina Ismail, Shatriah |
| author_facet | Khairuddin, Othman Li Min, Evelyn-Tai Mohd Noor, Raja-Azmi Muhammed, Julieana Ahmad Tajudin, Liza-Sharmini John, Tharakan Alwi, Muhd Besari Embong, Zunaina Ismail, Shatriah |
| author_sort | Khairuddin, Othman |
| building | USM Institutional Repository |
| collection | Online Access |
| description | INTRODUCTION: Hyphema and orbital apex syndrome occurring concurrently in a patient with herpes zoster ophthalmicus have not been reported previously. We present a case with these unique findings and discuss the pathogenesis of these conditions and their management.
PRESENTATION OF CASE: A 59-year-old Malay lady with underlying diabetes mellitus presented with manifestations of zoster ophthalmicus in the left eye. Two weeks later, she developed total hyphema,and complete ophthalmoplegia suggestive of orbital apex syndrome. She was treated with combinationof intravenous acyclovir and oral corticosteroids, and regained full recovery of ocular motility. Totalhyphema persisted, and she required surgical intervention.
DISCUSSION: Hyphema is postulated to occur due to an immune vasculitis affecting the iris vessels. Orbitalapex syndrome is probably due to an occlusive vasculitis affecting the vasculature of the extraocular muscles and optic nerve, resulting from a direct invasion by varicella zoster virus or infiltration of perivascularinflammatory cells. Magnetic Resonance Imaging of the brain is essential to exclude possibility of localcauses at the orbital apex area.
CONCLUSION: Herpes zoster ophthalmicus is an uncommon ocular presentation. Managing two concur-rent complications; persistent total hyphema and orbital apex syndrome is a challenging clinical situation.Early diagnosis and prompt treatment are essential to prevent potential blinding situation. |
| first_indexed | 2025-11-15T17:24:45Z |
| format | Article |
| id | usm-36837 |
| institution | Universiti Sains Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T17:24:45Z |
| publishDate | 2017 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | usm-368372017-09-29T08:11:23Z http://eprints.usm.my/36837/ Concurrent hyphema and orbital apex syndrome following herpeszoster ophthalmicus in a middle aged lady Khairuddin, Othman Li Min, Evelyn-Tai Mohd Noor, Raja-Azmi Muhammed, Julieana Ahmad Tajudin, Liza-Sharmini John, Tharakan Alwi, Muhd Besari Embong, Zunaina Ismail, Shatriah R5-130.5 General works INTRODUCTION: Hyphema and orbital apex syndrome occurring concurrently in a patient with herpes zoster ophthalmicus have not been reported previously. We present a case with these unique findings and discuss the pathogenesis of these conditions and their management. PRESENTATION OF CASE: A 59-year-old Malay lady with underlying diabetes mellitus presented with manifestations of zoster ophthalmicus in the left eye. Two weeks later, she developed total hyphema,and complete ophthalmoplegia suggestive of orbital apex syndrome. She was treated with combinationof intravenous acyclovir and oral corticosteroids, and regained full recovery of ocular motility. Totalhyphema persisted, and she required surgical intervention. DISCUSSION: Hyphema is postulated to occur due to an immune vasculitis affecting the iris vessels. Orbitalapex syndrome is probably due to an occlusive vasculitis affecting the vasculature of the extraocular muscles and optic nerve, resulting from a direct invasion by varicella zoster virus or infiltration of perivascularinflammatory cells. Magnetic Resonance Imaging of the brain is essential to exclude possibility of localcauses at the orbital apex area. CONCLUSION: Herpes zoster ophthalmicus is an uncommon ocular presentation. Managing two concur-rent complications; persistent total hyphema and orbital apex syndrome is a challenging clinical situation.Early diagnosis and prompt treatment are essential to prevent potential blinding situation. Elsevier 2017 Article PeerReviewed application/pdf en http://eprints.usm.my/36837/1/%28Concurrent_hyphema_and_orbital%29_1-s2.0-S221026121630548X-main.pdf Khairuddin, Othman and Li Min, Evelyn-Tai and Mohd Noor, Raja-Azmi and Muhammed, Julieana and Ahmad Tajudin, Liza-Sharmini and John, Tharakan and Alwi, Muhd Besari and Embong, Zunaina and Ismail, Shatriah (2017) Concurrent hyphema and orbital apex syndrome following herpeszoster ophthalmicus in a middle aged lady. International Journal of Surgery Case Reports, 30. pp. 197-200. ISSN 2210-2612 http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| spellingShingle | R5-130.5 General works Khairuddin, Othman Li Min, Evelyn-Tai Mohd Noor, Raja-Azmi Muhammed, Julieana Ahmad Tajudin, Liza-Sharmini John, Tharakan Alwi, Muhd Besari Embong, Zunaina Ismail, Shatriah Concurrent hyphema and orbital apex syndrome following herpeszoster ophthalmicus in a middle aged lady |
| title | Concurrent hyphema and orbital apex syndrome following herpeszoster ophthalmicus in a middle aged lady |
| title_full | Concurrent hyphema and orbital apex syndrome following herpeszoster ophthalmicus in a middle aged lady |
| title_fullStr | Concurrent hyphema and orbital apex syndrome following herpeszoster ophthalmicus in a middle aged lady |
| title_full_unstemmed | Concurrent hyphema and orbital apex syndrome following herpeszoster ophthalmicus in a middle aged lady |
| title_short | Concurrent hyphema and orbital apex syndrome following herpeszoster ophthalmicus in a middle aged lady |
| title_sort | concurrent hyphema and orbital apex syndrome following herpeszoster ophthalmicus in a middle aged lady |
| topic | R5-130.5 General works |
| url | http://eprints.usm.my/36837/ http://eprints.usm.my/36837/ http://eprints.usm.my/36837/1/%28Concurrent_hyphema_and_orbital%29_1-s2.0-S221026121630548X-main.pdf |