In this paper, we want to report the clinical findings and the treatment strategies of a patient with herpes zoster ophthalmicus accompanying with optic nerve involvement. He first admitted with high intraocular pressure and later clinical signs of herpes zoster ophthalmicus appeared on the skin and the anterior segment of right eye. Sudden and painless visual loss on the right eye has developed at the fourth day of oral acyclovir and antiglaucomatous treatment. Visual acuity on the right eye was at the level of hand motion, and there was relative afferent pupillary defect. Besides anterior segment findings, right disc was swollen and the margins were blurred at the nasal part. Intravenous acyclovir (10 mg/kg TID, 10 days) and oral prednisolone at a dosage of 1 mg/kg/day were started. One week later, the visual acuity was 0.6 on the right eye and the visual field defect had improved. Cellular reactions in the anterior chamber and keratic precipitates were disappeared, nasal portion of the optic disc became pale.