Presumed Herpes Zoster Ophthalmicus Reactivation Following Recombinant Zoster Vaccination. Issue 2 (February 2021)

• Record Type: Journal Article
• Authors: Jabbour, Samir; Shekhawat, Nakul S.; Chen, Ariel; Woreta, Fasika A.
• Is Part Of: Cornea. Volume 40:Issue 2(2021)
• Publication Date: 2021-02
• Subjects: herpes zoster -- herpes zoster ophthalmicus -- vaccination -- Shingrix; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000002537
• Languages: English
• ISSNs: 0277-3740

Abstract

Abstract : Purpose: To report a case of herpes zoster ophthalmicus (HZO) reactivation after recombinant zoster vaccination. Methods: A 78-year-old woman, with a history of HZO 20 years ago, was referred for progressive corneal thinning in her left eye that started 1 week after her second dose of recombinant zoster vaccination. Results: At presentation, visual acuity was counting fingers. Corneal sensation was markedly decreased. Slit lamp examination revealed a temporal paracentral epithelial defect 1.5 × 2.0 mm in size with 40% thinning and surrounding stromal inflammation suggestive of stromal keratitis with ulceration. The patient was started on oral valacyclovir, topical erythromycin ointment, and hourly topical lubrication. A bandage contact lens was placed and was replaced 1 week later with self-retained cryopreserved amniotic membrane ring. The ring was removed in the following week when the thinned area was epithelialized with no further evidence of stromal lysis. Conclusions: HZO reactivation after recombinant zoster vaccination is uncommon but possible. Ophthalmologists should remain aware of potential risks of zoster vaccination and take special precautions in patients with HZO history.