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Purpose: To identify clinical factors associated with the early reduction of corneal sensitivity (CS) in patients with herpes zosterophthalmicus (HZO). Methods: Total 30 subjects were divided into two groups according to the occurrence of an early reduction of CS (group 1,normal CS; group 2, decreased CS). The demographics, ocular manifestations of HZO, and the ocular surface parameters werecompared between two groups. Then, the relative risks of variables were analyzed to expect the early decrease of CS by HZOusing logistic regression analysis. Results: Among total 30 subjects, the CS decreased in 10 subjects (3.2 ± 1.4 cm, group 2) and the other 20 subjects revealednormal CS (6.0 ± 0.0 cm, group 1). The age was higher in the group 2 (67.0 ± 16.6 years) than in group 1 (48.0 ± 17.6 years,p = 0.013), but sex and the comorbidity of diabetes mellitus was not difference between groups. The presence of cornealpunctate epithelial erosions was a single factor among the ocular manifestations of HZO, which discriminated group 1 (5%)and group 2 (60%, p = 0.002). The ocular surface staining scores (i.e., National Eye Institute scores and Sjögren’s InternationalCollaborative Clinical Alliance ocular surface score) were higher in group 2 (p = 0.001 and p = 0.021, respectively) than ingroup 1. The existence of corneal punctate epithelial erosions revealed as a sole risk factor for the early reduction of CS (oddsratio = 33.085; p = 0.016). Conclusions: It is necessary to pay attention to the possible occurrence of neurotrophic keratopathy especially in older patientswith HZO showing an initial presence of corneal punctate epithelial erosions.