A 39 year-old pregnant woman at 34 weeks presented with peripheral retinal whitening suggestive of acute retinal necrosis with optic nerve involvement and visual acuity of 20/300 (A). Vitreous paracentesis revealed 800,000,000 copies/mL of VZV DNA by PCR. After 2 weeks of intravitreal foscarnet every 3 days and 2 months of oral valacyclovir 2 g PO TID, the retina remained attached, with resolution of retinitis, and improvement of vision to 20/200, limited by optic atrophy (B).