A 36-year-old man is admitted to the emergency department with a painful skin rash on the dorsum of his nose. Physical examination reveals that a herpetic lesion is affecting the dorsum of the nose and the eyeball. Which of the following nerves is most likely to be responsible for transmission of the virus to the eye?
A herpes rash on the dorsum of the nose is known as Hutchinson's sign. This indicates that the virus is located in cell bodies of the ophthalmic division of the trigeminal nerve. This nerve branches into nasociliary, frontal, and lacrimal branches. The nasociliary nerve has direct branches that carry sensory innervation from the eye. The nasociliary nerve also gives off the ethmoidal nerves that innervate the superior nasal mucosa, in addition to providing the origin of the dorsal nasal nerve. The supratrochlear nerve is a branch of the frontal nerve and carries sensory innervation from the skin superior to the orbit. The infraorbital nerve is a branch from the maxillary division of the trigeminal nerve and carries sensory innervation from the skin of the face between the orbit and the upper lips.
Nasociliary
Supratrochlear
Infraorbital
Posterior ethmoidal
Head & Neck