Trochlear nerve palsy in herpes zoster opthalmicus

Herpes zoster ophthalmicus (HZO) causes a wide range of ocular manifestations, and ophthalmoplegia is among the infrequent complications. The most commonly affected nerve is the third nerve, the least affected is the trochlear nerve. Herein, we describe two cases of isolated fourth nerve palsy associated with HZO. In both cases, the onset of ophthalmoplegia was shortly after the appearance of skin lesions, and both of the patients received oral acyclovir. Complete recovery was observed in a period of a few months