# Initial diagnosis of herpes zoster ophthalmicus complicated by central retinal artery occlusion and subsequent varicella-zoster virus encephalitis: a case report

## TL;DR

A 65-year-old man with herpes zoster ophthalmicus developed central retinal artery occlusion and later viral encephalitis, highlighting a rare and complex medical case.

## Contribution

This case report presents a rare complication of HZO with CRAO and subsequent encephalitis, offering insights into treatment challenges.

## Key findings

- HZO was complicated by sudden-onset central retinal artery occlusion in the left eye.
- Treatment with methylprednisolone pulse therapy failed to improve visual acuity.
- The case highlights the rare occurrence of viral-related CRAO following HZO diagnosis.

## Abstract

To report the unusual case of a herpes zoster ophthalmicus (HZO) complicated by central retinal artery occlusion and viral encephalitis.

A 65-year-old male with HZO who underwent intravenous acyclovir treatment complained of sudden onset blurry vision of his left eye. Central retinal artery occlusion (CRAO) was revealed. We administered methylprednisolone pulse therapy, yet resulted in no visual acuity improvement.

There were only a few cases reported to have CRAO after diagnosed HZO. This cause of viral-related CRAO led to a complicated treatment decision.