Herpetic Keratitis and Corneal Endothelitis Following COVID-19 Vaccination: A Case Series

Abstract

Herpetic corneal disease is the most common infectious cause of corneal blindness in developed countries. The majority of the infections are caused by the reactivation of the latent virus in the trigeminal ganglion. Environmental factors and physical stress are thought to contribute to viral reactivation. The pathognomonic lesion of the herpes simplex virus (HSV) is dendritic keratitis, which is visible on slit-lamp examination after fluorescein dye staining. A potential association between HSV reactivation and coronavirus disease 2019 (COVID-19) vaccines has been reported. In this case series, we present four cases of HSV reactivation in patients who received COVID-19 vaccination in Saudi Arabia from different medical centers. This report emphasizes the necessity of evaluating HSV reactivation as a potential side effect of COVID-19 vaccination. This is important because early diagnosis and timely management of herpetic lesions can potentially reduce the severity of infection.