Reactivation of the herpes zoster virus, or shingles, in the fifth cranial nerve can lead to herpes zoster ophthalmicus. In this condition, dendrite keratopathy along with uveitis can lead to marked pain and visual loss. Involvement of the skin at the tip of the nose, supplied by the nasociliary nerve, is often associated with ocular involvement. Treatment with oral acyclovir often can reduce symptoms and shorten the course of the disease. If ophtalmic involvement is suspected, the patent should be evaluated by an ophthalmologist.