A 55-year-old white man with a medical history of well-controlled type 2 diabetes, rheumatoid arthritis and fibromyalgia presented with progressively worsening, painless decline in vision of both eyes.
His ocular history was notable for keratoconus in both eyes, managed with contact lenses.
Two weeks earlier, he noticed darkening of his vision, “like looking through a dark curtain.” He also noted onset of vesicular lesions at the corner of both eyes, along with one vesicular lesion on the left upper eyelid, prompting presentation to a local eye doctor. After evaluation, he was suspected of