The patient presented with Herpes zoster ophthalmicus on her right face and right eye. This is a severe case of herpes zoster with external and internal ophthalmoplegia: total third nerve palsy with immobility of medial rectus, inferior rectus, superior rectus, inferior oblique. (Ptosis is not obvious on photograph because lids are being held, anisocoria is difficult to judge because the lower lid covers the pupil partially). There were also fourth, sixth and seventh nerve palsies, internal ophthalmoplegia, and sensory fifth nerve deficits.
Luviano, Damien, M.D., Los Angeles County¦2, Los Angeles, USA