Acute retinal necrosis is a distinct ocular viral syndrome with a potentially devastating visual outcome, traditionally treated with intravenous acyclovir followed by oral acyclovir. The goals of therapy include accelerating the resolution of the infection in the affected eye and prevention of contralateral involvement. Recently, several small case series and case reports have described the use of newer oral antivirals such as valacyclovir, famciclovir or valganciclovir, alone or in combination with adjunctive intravitreal foscarnet or ganciclovir injections for the treatment of acute retinal necrosis (1-4). The purpose of this article is to describe various therapies available to practitioners who may treat patients with acute retinal necrosis.