A 58-year-old woman presented with rash over the left side of the face and intense acute uveitis. Following careful review of the symptoms and dilated fundus examination unilateral optic neuritis was discovered. The rash was typical of varicella zoster dermatitis. Patients presenting with herpes zoster ophthalmicus should always undergo dilated fundus examination, as there is a potential risk of unexpected posterior segment inflammation. Early diagnosis and prompt treatment can avoid visual sequelae.
Optic neuritis complicating herpes zoster ophthalmicus in an immunocompetent patient
(A) Fotografia em lâmpada de fenda do olho direito (OD) evidenciando alterações irianas compatíveis com a síndrome de Cogan-Reese (síndrome ICE), com corectopia/ectrópio uveal e múltiplos nódulos pigmentados na superfície da íris. (B) Fotografia em lâmpada de fenda do olho esquerdo (OS) sem alterações irianas significativas. (C) Microscopia especular do OD mostrando redução da densidade endotelial (2.154 células/mm²), com acentuado pleomorfismo/polimegatismo (baixa hexagonalidade). (D) Microscopia especular do OS com densidade endotelial preservada (2.502,7 células/mm²) e morfologia celular sem alterações relevantes.
Freitas-NetoCA, CerónO, PachecoKD, PereiraVO, ÁvilaMP, FosterCS. Optic neuritis complicating herpes zoster ophthalmicus in an immunocompetent patient. Rev Bras Oftalmol. 2014;73(6):386-8.
Freitas-Neto,Clovis Arcoverde; Cerón,Olga; Pacheco,Katia Delalibera; Pereira,Viviane Oliveira; Ávila,Marcos Pereira; Foster,C. Stephen. Optic neuritis complicating herpes zoster ophthalmicus in an immunocompetent patient. Rev Bras Oftalmol., v. 73, n. 6, p. 386-388, Dec. 2014.
Freitas-Neto,C.A., Cerón,O., Pacheco,K.D., Pereira,V.O., Ávila,M.P., & Foster,C.S. (2014). Optic neuritis complicating herpes zoster ophthalmicus in an immunocompetent patient. Rev Bras Oftalmol.,73(6), 386-388.
Freitas-Neto,Clovis Arcoverde and Cerón,Olga and Pacheco,Katia Delalibera and Pereira,Viviane Oliveira and Ávila,Marcos Pereira and Foster,C. Stephen. Optic neuritis complicating herpes zoster ophthalmicus in an immunocompetent patient. Rev Bras Oftalmol. [online]. 2014, vol. 73, n. 6, [cited 2026-03-11], pp.386-388. Available from: <https://www.rbojournal.org/en/article/optic-neuritis-complicating-herpes-zoster-ophthalmicus-in-an-immunocompetent-patient/>. ISSN 0034-7280.