ABSTRACT
Chikungunya fever is a vector borne virus that typically causes a self-limiting systemic illness with fever, skin rash and joint aches 2 weeks after infection. We present the case of a 69-year-old woman presenting with an acute unilateral optic neuropathy as a delayed complication of Chikungunya virus (CHIKV) infection contracted during a recent trip to the West Indies. She presented to our ophthalmology department with acute painless visual field loss in the right eye and a recent flu-like illness. She was found to have a right relative afferent pupillary defect (RAPD) with unilateral optic disc swelling. Serology confirmed recent CHIKV infection. Treatment with intravenous methylprednisolone was delayed while awaiting MRI scans and serology results. At 5-month follow-up, there was a persistent right RAPD and marked optic atrophy with a corresponding inferior scotoma in the visual field.
Subject(s)
Chikungunya Fever/complications , Papilledema/virology , Pupil Disorders/virology , Vision Disorders/virology , Aged , Chikungunya Fever/diagnosis , Female , Humans , Papilledema/drug therapy , Visual FieldsABSTRACT
OBJECTIVE: To report the association between herpes simplex virus (HSV) and iris atrophy with pupillary dilation. DESIGN: Retrospective case series. PARTICIPANTS: Patients with a clinical diagnosis of HSV keratouveitis seen between November 1993 and April 1994 in a single university uveitis clinic. There were 6 women and 7 men, aged 17 to 69 years (mean age 44.4 years). METHODS: Patient information was collected, including history and medications used, and a complete ophthalmologic evaluation was performed, with careful documentation of iris detail and pupillary size. RESULTS: Thirteen of 13 patients demonstrated some degree of iris atrophy; 9 of 13 had pupillary dilation on the affected side despite not being on dilating drops. CONCLUSIONS: Iris atrophy and pupillary dilation in a patient with unexplained anterior uveitis suggests the diagnosis of HSV keratouveitis.
Subject(s)
Eye Infections, Viral/virology , Herpes Simplex/virology , Iris/pathology , Pupil Disorders/virology , Uveitis, Anterior/virology , Adolescent , Adult , Aged , Atrophy , Eye Infections, Viral/pathology , Female , Follow-Up Studies , Herpes Simplex/pathology , Humans , Male , Middle Aged , Pupil Disorders/pathology , Retrospective Studies , Uveitis, Anterior/pathology , Young AdultABSTRACT
Pupillary paralysis and paresis of the peripheral facial nerve on the left side was found in a 68-year-old man with concussion and herpes zoster ophthalmicus on the left eye. Post mortem examination showed no sign of intracranial hemorrhage. The cause of death was pulmonary oedema and aspiration. The neurological signs were probably caused by herpes zoster affection of the oculomotor and optic nerves in association with the facial nerve paresis induced by zoster.
