Abstract
Herpes zoster Ophthalmicus (HZO) affecting the ophthalmic division (V1) of the trigeminal nerve. HZO may cause extraocular muscle palsies, with the third nerve being the most commonly affected and the fourth nerve the least. The combined involvement of the optic nerve and isolated paralysis of the eye muscle is very rare, with only limited case reports documenting this complication of ocular herpes zoster. This case report also describes a case of optic nerve involvement with 6th nerve palsy, which was treated with corticosteroid and valacyclovir.