**Core Concept**
Herpes zoster keratitis is an ocular complication of varicella-zoster virus reactivation in the trigeminal nerve, leading to inflammation of the cornea. This condition is characterized by immune-mediated damage to the corneal epithelium, endothelium, and stroma.

**Why the Correct Answer is Right**
Herpes zoster keratitis typically presents with symptoms such as eye pain, redness, and decreased vision. The condition often involves the formation of dendritic ulcers, which are linear or branching lesions on the corneal surface. These ulcers are caused by the viral replication within the corneal cells, which leads to cell lysis and subsequent inflammation.

**Why Each Wrong Option is Incorrect**
**Option A:** This option does not directly relate to the typical presentation or complications of Herpes zoster keratitis.

**Option B:** This option is incorrect because Herpes zoster keratitis can indeed cause corneal thinning and perforation, especially if left untreated.

**Option C:** This option is incorrect because Herpes zoster keratitis often presents with decreased vision due to corneal scarring or inflammation.

**Option D:** This option is incorrect because Herpes zoster keratitis can cause severe eye pain, which is a hallmark symptom of this condition.

**Clinical Pearl / High-Yield Fact**
Herpes zoster keratitis can be managed with antiviral medications such as acyclovir or valacyclovir, which can help reduce the severity and duration of the condition. Early treatment is crucial to prevent long-term complications.

**Correct Answer:** B. Corneal thinning and perforation.