Background: Disciform Keratitis is one of the many presentations that can occur in Herpes Zoster Ophthalmicus. It is a form endotheliitis that is accompanied by corneal swelling due to cellular dysfunction. Management of these cases involves oral antivirals and topical corticosteroids; extended prophylactic antiviral therapy should also be considered.

Case report: A 57-year-old white male who was immunocompromised due to leukemia presented with decreased vision accompanied with central corneal swelling and a circular area of keratic precipitates. He had an ocular history significant for skin lesions involving the ipsilateral eyelid about one month prior. When treated with oral valacyclovir and topical prednisolone, he responded well and had an excellent visual recovery. Due to herpes zoster recurrence and his immunocompromised status, we advised this patient to use prophylactic antivirals for one year following the event. 

Conclusion: Herpes Zoster is a common disease, and ocular involvement is frequently seen. This case outlines a classic presentation of disciform keratitis due to herpes zoster. Additionally, this case highlights prophylactic treatment that should be considered, especially when the affected patients are immunocompromised and prone to recurrence. If not managed appropriately, patients may suffer from profound vision loss. Timely diagnosis and treatment are essential to help patients obtain their best visual outcome.