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Reactivation of herpes simplex keratitis following vaccination for COVID-19
  1. James Richardson-May1,
  2. Alice Rothwell2 and
  3. Mohammed Rashid2
  1. 1Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2Ophthalmology, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
  1. Correspondence to Dr James Richardson-May; jamesrichardsonmay{at}


An 82-year-old man with a history of herpes simplex keratitis 40 years previously presented with recurrence, 1 day following vaccination for novel COVID-19. His condition worsened despite topical treatment with ganciclovir gel. A diagnosis of herpetic stromal keratitis was made, requiring systemic aciclovir, topical prednisolone, moxifloxacin and atropine, and oral doxycycline. He improved clinically on treatment, with some residual corneal scarring. Visual acuity improved from 6/36 corrected at presentation, to 6/24 following treatment. Clearly, public and personal health benefits from vaccination are hugely important and we would not suggest avoiding vaccination in such patients. It is, however, important for ophthalmic providers to be aware of the rare potential for reactivation of herpetic eye disease following vaccination to enable prompt diagnosis and treatment.

  • ophthalmology
  • anterior chamber
  • public health

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  • Contributors JR-M contributed to project conception, research, writing and preparation of manuscript and submission. AR contributed to writing and preparation of the manuscript. MR contributed to project conception and research for the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.