Topic: The clinical features and management strategies for varicella-zoster virus (VZV) infections of the cornea, lids, and adnexa. Clinical Relevance: Herpes zoster ophthalmicus (HZO) can result in a myriad of chronic and recurrent complications that may be sight threatening. Surgical intervention is the mainstay of treatment, and advancements in this area may lessen the complications of HZO if correctly implemented. Methods: Literature review of pertinent topics, authors, and journals utilizing the National Institutes of Health PubMed service. Results: A higher rate of treatment success for VZV-related complications was obtained when any preexisting ocular inflammation, increased intraocular pressure, lagophthalmos, dry eye, exposure, or neurotrophic keratitis was treated and under control before attempting ocular surgery. Conclusion: Options are available to manage ophthalmic complications of HZO and reduce the risk of treatment failure.