Herpes Zoster Ophthalmicus with Unilateral Sixth Nerve Palsy

The ophthalmoplegia can be bilateral, or less frequently, contra-lateral to the side of the rash.4 A few cases describing this infrequent finding have been published in the literature up to date, in a pediatric5 and a senior adult patients.6 The pupil can be affected in isolation (internal ophthalmoplegia) due to dysfunction of the ciliary ganglion.7 Clinically, lesions on the tip of the nose resulted from nasociliary branch involvement have been described as Hutchinson’s sign which is a predictor for ocular inflammation and corneal denervation.8 Here, we describe a case of HZO that developed unilateral abducens nerve palsy a few days after the onset of the rash. Conflict of Interest The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Herpes zoster ophthalmicus natural history, risk factors, clinical presentation, and morbidity.