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Recurrence of varicella zoster virus (VZV) is a painful condition that can have long-term sequelae especially in the elderly. However, cornea specialists may be adding another relative contraindication: those patients with a history of prior herpes zoster ophthalmicus (HZO). The 63-year-old male patient's herpes zoster keratouveitis and neurotrophic keratopathy was quiescent for three and a half years without medication. University of Toronto, after she saw mild recurrences of iritis after vaccination in some patients with a history of herpes zoster ophthalmicus.


Even more concerning was the case of a colleague's patient with a history of treatable recurrent bouts over many years of mild HZV-related keratitis and hypertensive iritis.
Ocular inflammation from herpes zoster ophthalmicus can recur or recrudesce on its own even in the absence of the vaccine, he said.
Reports of acute retinal necrosis?including isolation of the vaccine strain in one?and exacerbation of zoster interstitial keratitis and keratouveitis after vaccination have led Dr.
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Post-herpetic neuralgia is a very painful complication and one that can have a serious effect on the quality of life of many individuals. There have been several reports of recurrence of HZO after patients received the herpes zoster vaccine. Holland, MD, professor of ophthalmology, University of Cincinnati, and director, cornea service, Cincinnati Eye Institute. Liesegang to continue to recommend the zoster vaccine for all patients over age 50 except for those who are immunocompromised or on steroids.  Jay Pepose, MD, director, Pepose Vision Institute, and professor of clinical ophthalmology, Washington University School of Medicine, St.


Pepose to elicit histories of any immunosuppressive drugs or immunosuppressive conditions in patients that may contraindicate vaccination. Pepose recommends the zoster vaccine for patients with a history of HZO but he carefully monitors them following vaccination. The herpes zoster vaccine has been recommended for adults 60 years and older, and in some cases 50 years and older, whether or not the patient had a prior episode of VZV. Louis, agreed that it remains unclear whether the recurrence stems from a reactivation of latent varicella-zoster, from the vaccine strain itself or from a boost in immunity.
He also recommends against the zoster vaccine for patients who are allergic to neomycin, gelatin, or other components of the vaccine.




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