An 86-year-old white man initially had herpes zoster dermatopathy in the right V1 distribution, which was treated promptly with valacyclovir hydrochloride, 1 g 3 times per day. Several days after onset of the dermatopathy, he had pain, redness, and photophobia in the right eye. On examination of the right eye, centrally grouped keratoprecipitates (KPs) (without corneal stromal or epithelial involvement), 2+ cells, and flare were found. The AU was treated with topical prednisolone acetate, 1%. The patient developed a chronic low-grade AU in the right eye; it was well controlled with topical prednisolone acetate, 1%. He gradually developed mild microcystic corneal edema in the right eye, with specular microscopic imaging failing to reveal either a recognizable endothelial mosaic or guttae. The endothelial count in the contralateral eye was normal despite prior uncomplicated cataract surgery in both eyes. The microcystic edema was attributed to endotheliitis, possibly at the onset of the VZV AU as there were no recurrences of KPs or more than minimal AU. Three years after the initial visit, he was weaned completely off prednisolone acetate, 1%, after several months without any evidence of active AU.