A HIV patient presented with herpes zoster ophthalmicus. Which of the following nerve is MOST commonly involved?
High-Yield Explanation
Varicella zoster virus lying dormant within the trigeminal ganglion can reactivate and spread through the ophthalmic division of the trigeminal nerve. While almost any ophthalmic abnormality can occur as a result, grouped vesicles in a dermatomal distribution are a classic finding. Skin lesions on the tip of the nose (Hutchinson sign) can indicate risk of ocular involvement, as this area is innervated by the nasociliary branch of the ophthalmic division of cranial nerve V. Ref: Levsky M.E., DeFlorio P. (2010). Chapter 2. Ophthalmologic Conditions. In K.J. Knoop, L.B. Stack, A.B. Storrow, R.J. Thurman (Eds), The Atlas of Emergency Medicine, 3e.