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Chickenpox, shingles vaccine associated with corneal inflammation

Analysis of case reports identified an association between the varicella zoster vaccine and keratitis in both children and adults, according to recently presented findings.

Frederick W. Fraunfelder, MD, chair of the department of ophthalmology at the Missouri University School of Medicine and director of MU Health Care's Mason Eye Institute, stressed that while the occurrence was rare, primary care providers should be aware of a patient's keratitis history because of the risk for reactivation.

"Keratitis, or inflammation of the clear layer on the front of the eye, is a vision issue that can cause serious complications or even permanent damage to your vision if left untreated," Fraunfelder, who is also the director of the National Registry of Drug-induced Ocular Side Effects, said in a press release. "By studying case reports from national and international registries, we found at least 20 cases of keratitis occurred in children and adults within a month of administration of the chickenpox and shingles vaccine."

Reports from the registry showed that adults developed inflammation within 24 days of receiving the vaccine, and children developed symptoms within 14 days. According to the abstract, a majority of the cases were self-limited or resolved with treatment.

Fraunfelder said that most patients should be vaccinated despite the association with keratitis as long as physicians take the right steps.

"It's important to note that keratitis associated with these vaccines is very rare, and by itself is not a reason to forego vaccination," he said in the release. "But for patients who have a history of keratitis, we recommend they talk to their primary care physician before getting vaccinated. If these individuals are vaccinated, they should be closely monitored to ensure they don't experience corneal inflammation or additional scarring." – by Chelsea Frajerman Pardes

Reference:

Grillo AP and Fraunfelder RW. Varicella Zoster Vaccine-Associated Keratitis. Presented at: American Academy of Ophthalmology meeting. Nov. 17, 2015; Las Vegas.