Herpes zoster ophthalmicus and strabismus: a unique cause of secondary Brown syndrome

Broderick, Kevin; Raymond, Wilfred W.; Boden, John

doi:10.1016/j.jaapos.2017.06.003

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…15,16 Ironically, the initial cause of the canalicular obstruction may well be a risk factor for this occurrence of diplopia (scarring posttumor reconstruction, radiotherapy, lichen planus, ocular cicatricial pemphigoid, and herpetic canaliculitis). 17,18 However, it is not possible to establish these as etiological local factors as many of these factors are among the indications for canalicular bypass surgery. It is likely that these would be equally as prevalent in patients who do not develop restrictive diplopia following canalicular bypass surgery.…”

Section: Discussionmentioning

confidence: 99%

Diplopia Following the Insertion of a Canalicular Bypass Tube: Etiology, Risk Factors, Management, and Outcomes

Bladen

Mombaerts²,

Kakizaki

et al. 2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To report the etiology, management, and possible risk factors for diplopia after canalicular bypass surgery. Methods: A multicenter retrospective, noncomparative case series of patients who developed diplopia following canalicular bypass surgery were assessed. Results: Twenty-four cases of diplopia were identified across 12 institutions. Tubes were inserted as a primary procedure with external dacryocystorhinostomy (DCR) (1; 4%) or without DCR (10; 42%) or as a secondary procedure after external (8; 33%) or endonasal (5; 21%) DCR. Factors predisposing to local damage were noted in 17 (71%): these factors included preexisting autoimmune/inflammatory condition (7 cases), medial canthal tumor resection (5 cases), preoperative radiotherapy (2 cases), 2 drug treatments (topical and systemic), and 1 local surgery. Horizontal diplopia was due to restriction of abduction and first noted at a median of 3.5 months (mean: 17.8 months, range: 1 day to 112 months) and persisted in 23 (96%) cases with a mean restriction of −2, affecting primary gaze in 4 patients and activities of daily living in 13 (42%). Seventeen patients received various treatments: 10 were operated on resulting in cure in 1 and improvement in 9. A stable degree of diplopia persisted in all but one patient. Conclusions: Restriction of abduction causing horizontal diplopia is a rare complication with canalicular bypass surgery and a notably high proportion occurred after tube placement without DCR; carunculectomy was not ubiquitous. Although in some the diplopia may be improved with intervention, the chance of cure is low. This complication should probably be included during informed consent for canalicular bypass tubes.

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Section: Discussionmentioning

confidence: 99%

Diplopia Following the Insertion of a Canalicular Bypass Tube: Etiology, Risk Factors, Management, and Outcomes

Bladen

Mombaerts²,

Kakizaki

et al. 2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…It has been reported that extraocular muscle complete paralysis associated with HZO develops between one and two weeks after the appearance of skin lesions and usually shows significant improvement within two months. Recovery of diplopia can occur at intervals between two and 23 months [ 2 ]. One of our patients was treated with acyclovir and corticosteroids, the other patient was administered only acyclovir, and during six months of follow-ups, no improvement was observed in our two cases.…”

Section: Discussionmentioning

confidence: 99%

“…The most common complications of varicella zoster are gastroenterological infections, cranial nerve palsies, myelitis, meningitis, and stroke [ 1 ]. In HZO, the incidence of extraocular muscle paralysis ranges from 7% to 31%; however, most cases can be overlooked, as visual acuity is reduced in the affected eye and diplopia is seen in extreme gaze [ 2 ]. While the oculomotor nerve is more affected, the abducens and trochlear nerves are less affected.…”

Section: Introductionmentioning

confidence: 99%

Advanced Age and Multiple Comorbidities as Important Factors in Predicting Poor Prognosis in Herpes Zoster Ophthalmicus

Varoğlu¹,

Avarisli²

2021

Cureus

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The varicella-zoster virus (VZV) infection results in varicella (chickenpox) and is generally seen in immunocompromised persons. VZV virus remains latent in the ophthalmic branch in the trigeminal ganglion. When reactivated, herpes zoster ophthalmicus (HZO) develops and sometimes leads to chronic ocular complications, among which cranial nerve palsies are rarely seen. Though the third cranial nerve is most frequently involved, the fourth and sixth nerves may also be involved in some cases. Treatment includes systemic antiviral therapy and steroid administration. The prognosis is generally good when treatment is executed. Improvement can also be observed without treatment. In this article, we would like to highlight two such cases in which these two cranial nerves got involved following an episode of HZO. One is a 67-year-old female patient having diabetes mellitus (DM), hypertension (HT), and coronary heart disease with fourth and sixth cranial nerve complete palsy. The other is a 76-year-old male patient with HT, DM, and heart failure with only sixth cranial nerve complete palsy. Despite adequate treatment, both patients had a poor prognosis. Advanced age and the presence of multiple comorbidities are important factors in predicting poor prognosis in HZO cases.

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Herpes zoster ophthalmicus and strabismus: a unique cause of secondary Brown syndrome

Cited by 2 publications

References 6 publications

Diplopia Following the Insertion of a Canalicular Bypass Tube: Etiology, Risk Factors, Management, and Outcomes

Diplopia Following the Insertion of a Canalicular Bypass Tube: Etiology, Risk Factors, Management, and Outcomes

Advanced Age and Multiple Comorbidities as Important Factors in Predicting Poor Prognosis in Herpes Zoster Ophthalmicus

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