True posterior ischemic optic neuropathy associated with herpes zoster ophthalmicus

Although previous reports of ischemic optic neuropathy resulting from herpes zoster have appeared in the literature, these reports have not been convincing of a true optic neuropathy. The case presented is a true posterior ischemic optic neuropathy due to inflammation of the medial posterior ciliary artery, diagnosed on the basis of a deep, steep-sided altitudinal visual field defect. The herpes zoster infection also resulted in retinitis, damage to the iris sphincter, and corneal scarring. The effects of herpes zoster on the visual system are reviewed.