We report the treatment and prognosis of two patients who experienced pain in their face associated with skin lesions and acute decreased visual acuity and were diagnosed with optic neuritis caused by the herpes zoster virus.

Two patients were diagnosed with herpes zoster ophthalmicus after experiencing an acute decrease in visual acuity and were sent to our clinic for examination. On ophthalmic evaluation, the results were positive for relative afferent pupillary defect (RAPD) and showed abnormal VEP levels. On MRI T1, one case showed a high signal along the optic nerve sheath. Both patients with optic neuritis were treated with Acyclovir (Zovirax®, GlaxoSmithKline, U.K.), which is an antiviral drug, at a dose of 10 mg/kg every 8 hours for 5 days, and a combination of prednisolone at a dose of 250 mg every 6 hours. After general therapy, they took Acyclovir (250 mg) orally 3 times daily for 14 days, with steroids (40 mg), and decreased the dosage after two weeks. We saw no improvement of visual acuity in either case, which still showed RAPD.

Optic neuritis secondary to herpes zoster ophthalmicus rarely occurs, but it is difficult to treat and has a poor prognosis. We should keep in mind that optic neuritis can occur in patients who were diagnosed with herpes zoster ophthalmicus.