A retrospective analysis of 171 patients with herpes zoster ocular infection has been carried out to determine the effect of treatment with either topical acyclovir, topical steroids, or a combination of both. Acyclovir was superior to steroids and to the combination. Treatment with topical acyclovir was on average 54 days compared with 200 days with steroids, and recurrences were 6% with acyclovir compared with 50% with steroids.