Expected headings
"MRI"
"Symptoms range from unilateral pain in an ophthalmic dermatomal distribution accompanied by a vesicular rash to serious intraocular complications, including conjunctivitis, keratitis, uveitis, episcleritis, scleritis, retinitis, optic neuritis, perineuritis, orbital muscle palsies and myositis 1,2. Hutchinson sign is characterised by skin lesions at the tip, side, or root of the nose and is a strong indicator of ocular inflammation and diminished corneal sensation in herpes zoster ophthalmicus 3,4."
"Herpes zoster ophthalmicus results from a latent infection of the ophthalmic division of the trigeminal nerve. The ophthalmic division is further subdivided into the nasociliary, frontal, and lacrimal branches, of which the frontal nerve is most commonly involved with herpes zoster ophthalmicus 1. The nasociliary nerve innervates the ethmoidal sinuses, skin of both eyelids, the tip of the nose, conjunctiva, sclera, cornea, iris, and choroid."
"The pathophysiology of the diffuse and severe visual complications of herpes zoster ophthalmicus incorporates components of viral infection, inflammatory and immune-mediated reactions, vasculitis, neuritis, and tissue scarring 1."
"MRI demonstrates orbital inflammation with hyperintense oedematous changes and abnormal contrast enhancement in the frontal, preseptal and periocular regions 6."
"Globe involvement may also be demonstrated in the form of scleritis with scleral thickening and enhancement, uveitis and endophthalmitis 6."