In the period 1950 through 1982, there were 294 episodes of ocular herpes simplex virus infection in 151 residents of Rochester, Minn. Recurrence rates assessed by life-table methods after the first episode were 9.6% at 1 year, 22.9% at 2 years, and 63.2% at 20 years. Recurrence rates appeared to rise following repeated episodes. Ocular herpes simplex affecting both eyes at the same and/or different episodes was seen in 18 patients (11.9%). One fifth of patients had lid involvement alone, while a third had solely superficial corneal involvement. Deep corneal disease or uveitis was relatively uncommon. Therapy during the early period was varied, but significant complications were uncommon. Ninety percent of the eyes maintained visual acuity of 20/40 or better. The economic impact, measured in terms of days of active disease and physician visits, was substantial.