A 44-year-old HIV-positive Hispanic man presented with painful herpes zoster of his right forehead (Figure 125-1). He was particularly worried because his right eye was red, painful, and very sensitive to light (Figure 125-2). On physical examination there was significant conjunctival injection, corneal punctate epithelial erosions, and clouding, and a small layer of blood in the anterior chamber (hyphema). The pupil was somewhat irregular. Along with the hyphema and ciliary flush, this indicated an anterior uveitis. The patient had a unilateral ptosis on the right side with limitations in elevation, depression, and adduction of the eye secondary to cranial nerve III palsy from the zoster. The patient was immediately referred to ophthalmology and the anterior uveitis, corneal involvement, and cranial nerve III palsy were confirmed. The ophthalmologist started the patient on topical ophthalmic preparations of erythromycin, moxifloxacin, prednisolone, and atropine. Oral acyclovir was also prescribed. Unfortunately, the patient did not return for follow up until 6 months later when he returned to the ophthalmologist with significant corneal scarring (Figure 125-3). The patient is currently on a waiting list for a corneal transplantation.