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59 EW CORNEA May 2016 5. Khalifa YM, et al. Exacerbation of zoster in- terstitial keratitis after zoster vaccination in an adult. Arch Ophthlmol. 2010;128:1079–1080. There are several case reports of patients immunized with the chickenpox vaccine developing herpes zoster ophthalmicus, and a growing body of research has linked the live attenuated shingles (herpes zoster) vaccine (Zostavax, Merck, Whitehouse Station, New Jersey) to the possibility that it could reacti- vate prior infections of herpes zoster ophthalmicus. 1,2,3 Shingles as a whole is caused by a reactivation of the chicken- pox virus in a patient. This virus reactivating in a specific region of the fifth cranial nerve can result in vision-threatening herpes zoster ophthalmicus. While the Centers for Disease Control and Prevention still rec- ommends the shingles vaccine for people 60 years old and older, some studies have found reoccurrence of ocular issues after this vaccination. 4,5 Dr. Fraunfelder said the work being done to research the ocular effects of drugs, vaccines, and other substances is important. "It is important because spon- taneous reports are the first 'signal' that something is occurring after a drug is marketed," he said. "Many of the adverse reactions we know about today come from post-market surveillance. A perfect example is gastric ulcers from aspirin. We didn't know this until 50 years after aspirin was on the market." These findings regarding the chickenpox vaccine and corneal inflammation have been submitted to the journal Ophthalmology as an annual meeting paper. EW References 1. Chouliaras G, et al. Vaccine-associated herpes zoster ophthalmicus and encephalitis in an immunocompetent child. Pediatrics. 2010;125:e969–72. 2. Van Aelst S, et al. A healthy 2.5-year-old boy with herpes zoster ophthalmicus as prima- ry presentation. J Pediatric Infect Dis Soc. 2015;4:e160–e162. 3. Hwang CW, et al. Reactivation of herpes zoster keratitis in an adult after varicella zos- ter vaccination. Cornea. 2013;32:508–509. 4. Sham CW, et al. Uveitis exacerbation after varicella-zoster vaccination in an adult. Arch Ophthalmol. 2012;130:793–794. Editors' note: Dr. Fraunfelder has no financial interests related to his comments. Contact information Fraunfelder: fraunfelderf@health.missouri.edu Join the largest subspecialty society representing the fields of cornea and external disease. Member Benefits • Cornea: The Journal of Cornea and External Disease • Annual Meetings: Select discounted registration at membership events and educational programs • Exclusive eligibility for the International Corneal Training Grant Program ~ Cornea ED • Kera-net: The online forum for the exchange of clinical and scientific information • Cornea Society News mailed quarterly www.CorneaSociety.org Save the Date World Cornea Congress VIII Singapore 2020 July 8-9, 2020

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