The patient presents with herpes zoster opthalmicus, resulting from reactivation of the varicella-zoster virus in the first division of the trigeminal nerve. In addition to the corneal, conjunctival, and periorbital findings, the nasociliary branch of the first division of the trigeminal nerve results in involvement of the tip of the nose. The mainstay of treatment is oral antiviral therapy, typically with acyclovir, famcyclovir, or valacyclovir. Topical corticosteroids may also be used to decrease inflammation, and they do not seem to exacerbate the keratitis.
