Herpes Zoster Ophthalmicus Following Endodontic Treatment: A Case Report

Herpes zoster ophthalmicus, resulting from varicella-zoster virus reactivation along the ophthalmic division of the trigeminal nerve, is a rare but potentially sight-threatening condition that warrants awareness in clinical dental practice. A 36-year-old male presented 3 days after nonsurgical root canal treatment of the right maxillary first molar with severe migraine-like neuropathic pain, unilateral vesiculobullous eruptions along the V1 dermatome, periorbital edema, and conjunctival hyperemia. The treated tooth exhibited no remarkable clinical or radiographic findings. Dermatological evaluation confirmed herpes zoster ophthalmicus, and systemic antiviral therapy resulted in complete resolution by the 6-month follow-up. This case underscores the need to broaden the differential diagnosis when post-endodontic symptoms are disproportionate to or inconsistent with clinical findings. Early recognition and prompt referral are critical in preventing vision-threatening complications.