A 61-year-old woman presented with acute vision loss in her right since 1 day. Her medical history included hypertension, cerebral aneurysm, and Alzheimer’s dementia. She was on oral acyclovir for herpes zoster infection involving the trigeminal nerve for a week. At the initial visit, her visual acuity was count fingers in the right eye and 16/20 in the left eye. The corresponding intraocular pressure values were 13 mmHg and 12 mmHg, respectively. On the physical examination, the patient exhibited vesicles on her right forehead, scalp, and upper eyelid. Slit lamp biomicroscopy revealed conjunctival hyperemia and mild corneal erosion in the right eye. Inflammatory cells with Grade 1+ were present in the anterior chamber. On the fundus examination, multiple inflammatory lesions were observed at the posterior pole, along with exudative detachment of the macula. The left eye showed no abnormalities. Choroidal folds with an irregular overlying retinal pigment epithelium (RPE) and hyper-reflective spots in the choroid layer were observed on optical coherence tomography (OCT). Fluorescein angiography (FA) presented a stippled pattern of hyperfluorescence in the late phase. A mixed pattern of hypo- and hyperpermeability was observed in both the early and late phases of indocyanine green (ICG) angiography. Polymerase chain reaction analysis of intraocular fluid showed positivity for VZV and negativity for herpes simplex type 1/2 and cytomegalovirus. Other laboratory examinations, including blood cell count and examinations for liver and renal function and angiotensin converting enzyme, showed normal findings. Serology for syphilis, toxoplasmosis, and human immunodeficiency virus (HIV) yielded negative findings. The patient was diagnosed with VZV-associated chorioretinitis and admitted. Intravenous acyclovir was immediately initiated. Oral prednisolone (30 mg) was added for relieving the inflammatory reaction and was slowly tapered. Topical ganciclovir ointment was applied for faster intraocular penetration and topical steroids were also used. After 2 weeks of treatment with intravenous acyclovir, the lesion resolved, with RPE undulation, and the visual acuity in the right eye improved to 20/20.