Herpes zoster ophthalmicus complicated by complete ophthalmoplegia and signs of pilocarpine hypersensitivity. A case report and literature review.

We report a case of zona ophthalmica complicated with a complete ophthalmoplegia. In the literature only 19 cases have been reported the last 30 years, with a variety of possible pathophysiological mechanisms. Our patient's mydriasis reacted to diluted pilocarpine 0.125% which is a sign of Adie's pupil and is not supposed to occur in mydriasis caused by a third nerve palsy. We review the literature on the possible pathogenesis of this hypersensitivity.