A 40-year-old immunocompetent man presents with dermatomal grouped vesicles on an erythematous base over the T6 dermatome. The most serious ocular complication from herpes zoster ophthalmicus occurs when which branch is involved?
- A Lacrimal branch of V1
- B Frontal branch of V1
- C Nasociliary branch of V1 (Hutchinson's sign) ✓
- D Zygomaticotemporal branch of V2
Correct answer: C. Nasociliary branch of V1 (Hutchinson's sign)
Explanation
Hutchinson's sign — vesicles on the tip/side of the nose — indicates involvement of the nasociliary branch of the ophthalmic division (V1) of the trigeminal nerve, which supplies the tip of the nose and the eye (ciliary body, iris, cornea, conjunctiva). Its presence predicts a 76% risk of ocular complications (keratitis, uveitis, episcleritis), compared to ~34% without Hutchinson's sign. Any rash near the eye warrants urgent ophthalmological review and systemic acyclovir.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.