most common presentation of acute herpes zoster of the face
Ophthalmic zoster, a herpetic eruption in the V1 distribution of the trigeminal nerve, is the most common. Pain may precede the eruption by several days. This type of facial herpes is the most dangerous, as the viral vesicles may involve the eye, leading to blindness in severe untreated cases. In addition to oral antiviral treatment with acyclovir, the eye must be protected from secondary infection. Like other herpes infections, postherpetic neuralgia is a dreaded sequela, and occurs more commonly in the elderly.