Manifestation of Herpetic Eye Disease after COVID-19 Vaccine: A UK Case Series

Abstract

ABSTRACT Purpose To highlight the potential risk of herpetic eye disease (HED) reactivation following COVID-19 vaccine. Methods Retrospective analysis of all patients who presented with HED within 28 days post-first dose COVID-19 vaccination. Results Eleven eyes (n = 10 patients) were included. The mean interval between COVID-19 vaccination and ocular symptoms/signs was 12.3 ± 10.3 days. Four (40%) patients presented with HSV keratitis, and six (60%) patients presented with VZV keratitis (five had concurrent other signs of herpes zoster ophthalmicus). Common ocular signs included multiple scattered dendritic/pseudodendritic corneal epitheliopathy (90.9%), anterior uveitis (63.6%), and endothelitis (27.3%). All cases were successfully treated with topical and systemic antiviral treatment and/or topical corticosteroids (mean healing time = 3.9 ± 1.6 weeks). Conclusions Our case series highlights the potential temporal association between HED and COVID-19 vaccine. Prophylactic antiviral treatment is recommended in patients with a history of HED prior to COVID-19 vaccination.