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We report two patients who developed varicella zoster virus (VZV) ophthalmicus complicated by ipsilateral keratouveitis, and within 4 weeks developed acute retinal necrosis (ARN) in the contralateral eye. The ipsilateral retina was spared in each case. One patient had systemic lupus erythematosus (SLE) and the other Hodgkin's disease. Both patients were in remission at the time of presentation.

Bilateral combined retinal and choroidal detachment is a potentially blinding complication of ANCA-positive scleritis. Monitoring of ANCA titres is useful in the management of the disease.

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