Herpes Zoster 

Our patient presented with a focal, creamy-white inflammatory lesion obscured by dense vitritis. Vision was 20/80.

Interestingly, he gave a history of chickenpox five months earlier, which coincided with his visual symptoms.

Observation was recommended since he felt that his vision was improving. Two months later, the vitritis had improved, and the inflammatory lesion had resolved into a focal chorioretinal scar.

Learning Points:
We felt that our patient developed herpes zoster chorioretinitis secondary to an acute systemic varicella zoster infection.

Choroiditis is a somewhat rare finding with herpes zoster ophthalmicus (see Bloom and Snady-McCoy, AJO 1989;108;733-735). Our case beautifully shows both the acute and chronic sequelae of such an infection.