Herpes zoster ophthalmicus (HZO) is a consequence of reactivation of varicella zoster virus in the ophthalmic or the first division (V1) of the trigeminal nerve. The varicella zoster virus residing in the trigeminal ganglion gets reactivated causing involvement of the skin, ocular tissues and the adnexa leading to a significant visual morbidity. Keratouveitis can occur in both the acute and chronic phase of the disease. The diagnosis can be made easily on clinical history and examination. Management is based on the severity of the clinical presentation. This chapter is focused on the clinical features and management guidelines of keratouveitis in various stages of HZO.