Herpes zoster stromal disciform keratitis associated with endotheliitis in a 35-week pregnant woman

TL;DR

A pregnant Indigenous Australian woman developed a rare eye condition from the herpes zoster virus and had a positive treatment outcome.

Contribution

This is the first reported case of herpes zoster stromal disciform keratitis in an Indigenous Australian with a favorable outcome.

Findings

The patient showed classic signs of stromal disciform keratitis, including corneal edema and immune ring.

Treatment led to a favorable outcome despite the severity of symptoms during pregnancy.

The case highlights the importance of early diagnosis and management in rare ocular herpes zoster complications.

Abstract

Herpes zoster keratitis is a common manifestation of the varicella zoster virus. The active virus can cause epithelial keratitis early in the disease course, meanwhile later in the disease course, an inflammatory response can cause stromal or endothelial keratitis. A middle-aged pregnant woman exhibited classic ocular signs associated with Herpes’s stromal disciform keratitis of the left eye, including focal disk-shaped edema, descemet’s folds, keratic precipitates, diminished corneal sensations, and Wessley’s immune ring. The patient was symptomatic with severe left eye pain, lacrimation, photophobia, and hand-motion visual acuity. To the best of our knowledge, this case represents the first report and an interesting favorable outcome of herpes zoster stromal disciform keratitis management in an Indigenous Australian.

Figures