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Presentation type	E-poster
Title	Herpes Zoster Ophthalmicus – related orbital apex syndrome

Purpose	This poster aims to present a severe case of Herpes Zoster Ophthalmicus (HZO)-related orbital apex syndrome (OAS).
Methods	Case-report
Results	A 62–year-old immunocompromised woman presented with a one-week history of diminished vision, severe right hemifacial vesicular rash, total ptosis, mydriasis, ophthalmoplegia of the right eye and adjacent supraorbital hypoesthesia. MRI of the brain and orbit without gadolinium contrast, could not reveal any abnormalities. High dose methylprednisolone (48mg) and intravenous (IV) acyclovir (10 mg/kg for 10 days) were administered, as well as topical ganciclovir 5 times/day in the right eye and fusidic acid ointment 2 times/day at the skin lesions. Four months after presentation there were no more limitations of eye movements, however a subtotal ptosis, mild rigid mydriasis and corneal anesthesia persisted. Visual acuity was limited to 0.1. A subcapsular posterior cataract had developed.
Conclusion	HZO-related orbital apex syndrome is a rare sight-threatening entity. Immediate treatment with corticosteroids and antiviral medication is mandatory. An occlusive vasculitis due to direct viral invasion is suggested to be the cause of the OAS. After early recognition and intensive treatment, full recovery of eye movements is to be expected. Residual ptosis can be surgically corrected.
Conflict of interest	No

Authors 1

Last name	VAN SLYCKEN
Initials	A
Department	Ghent University Hospital, Dpt of ophthalmology
City	Ghent

Authors 2

Last name	Ninclaus
Initials	V
Department	Ghent University Hospital, Dpt of ophthalmology
City	Ghent

Authors 3

Last name	Roels
Initials	D
Department	Ghent University Hospital, Dpt of ophthalmology
City	Ghent