2025 Volume 52 Issue 1 Pages 107-111
Herpes zoster ophthalmicus develops in the region of the first trigeminal nerve and may be complicated by ocular lesions, so early diagnosis and treatment are important. In the present case, a woman in her late 60s presented with persistent headache that preceded the appearance of a skin rash. The patient was a woman in her late 60s with diabetes mellitus. She had conjunctival hyperemia and a hypesthesia in the V1 area, which led us to suspect herpes zoster ophthalmicus, and we performed a rapid PCR test of CSF, which was confirmed to be positive for VZV. Treatment with antiviral drugs was started before the appearance of skin rash, and the skin rash and keratitis appeared during the course of the treatment. We believe that the evaluation of physical examination findings such as sensory insensitivity and rapid PCR testing are useful in the early diagnosis and treatment of herpes zoster ophthalmicus without skin rash, and we report this case.
