Measles and the Eye

Eye Lens - USC Roski Eye InstituteThe controversy surrounding the measles vaccine and vaccinations in general have been in the media spotlight recently as a result of the measles outbreak that began last December at Disneyland. More than 100 measles cases in half a dozen states have been reported, which were directly linked to visitors or workers at Disneyland, according to California Health Officials.

USC Roski Eye Institute Physicians: How Measles Affects the Eyes

Measles is a highly contagious virus that is air borne, and simply by coughing or sneezing can spread rapidly to those who are unvaccinated. Measles can be prevented by vaccination with the Measles, Mumps, and Rubella (MMR) vaccine. MMR vaccine is recommended for children at age 12-15 months with a second dose at age four through six years. The most common symptoms include: fever, cough, runny nose and conjunctivitis (commonly known as pink eye). In addition three to five days after the first symptoms present, a red rash may appear that can spread from the face to the rest of the body. Most notably in almost one out of three patients, serious complications such as diarrhea, pneumonia, inflammation of the brain and eye disorders leading to blindness may occur. The most vulnerable groups at highest risk of complications due to measles infection include babies under the age of 1, immune-compromised children and adults, as well as pregnant women. Pregnant women diagnosed with the measles are at higher risk of miscarriage, stillbirth and premature delivery (born before 36 weeks gestation), as well as transmission of the virus to the fetus. Although relatively rare in the U.S., children in the developing world continue to be at higher risk given outbreaks within unvaccinated populations. According to the American Academy of Ophthalmology, measles remains a leading cause of mortality in children in the developing world. Increased worldwide travel may allow measles to regain a foothold if vaccination of children in the U.S. continues to decline.

Measles can cause vision loss and blindness

USC Roski Eye Institute’s ophthalmologists, who also staff Children’s Hospital Los Angeles, have treated patients who have eye problems from the measles. “In some cases vision loss has resulted in children infected with the measles virus as it has caused damage to the cornea (the clear front part of the eye) which becomes hazy and discolored in appearance,” said Jonathan Song, MD, Associate Professor of Ophthalmology, Keck School of Medicine of USC, and Director of the Cornea Service at the USC Roski Eye Institute.

Known as measles keratitis, infected children may tear excessively and need to avoid light due to extreme sensitivity. Song also notes that children who have poor diets and are deficient in vitamin A are at greater risk for more severe eye complications of measles. The measles virus can also affect the back of the eye especially the retina, which is the light-sensing part of the eye. “Measles virus can cause inflammation of almost any part of the back of the eye including the retina, blood vessels and optic nerve. Patients may lose vision due to swelling or scarring of the retina,” said Amir Kashani, MD, Assistant Professor of Ophthalmology, Keck School of Medicine of USC, and a retina specialist at the USC Roski Eye Institute.

“Women should know that contracting measles during pregnancy is dangerous to the baby who may become visually impaired due to corneal and retinal complications caused by the virus,” said Jesse BerryMD, an Assistant Professor of Ophthalmology, Keck School of Medicine and at the USC Roski Eye Institute.

Please seek treatment immediately if eye complications do arise from the measles. A comprehensive evaluation of your child’s symptoms and an accurate history must be obtained prior to diagnosis. Generally, topical antiviral or antibiotic ointments for infections are administered to patients diagnosed with keratitis or conjunctivitis. In more serious cases of acute measles retinopathy, systemic corticosteroids may be given. Preventive treatment options are available for patients who are at higher risk.

Moreover, what perhaps has not gained much media attention is that the measles vaccine also vaccinates for rubella and mumps (MMR). Not to be confused with rubeola, an alternate name for the measles, rubella can be a very serious condition. Pregnant women should be aware that rubella infections may also be dangerous to the developing baby. Rubella has been linked to cataracts, glaucoma and retinal degeneration during the development of the baby in the mother’s womb.

If you suspect that you or your family members may have an eye condition in a child with the measles infection or any eye concerns, please contact us for an appointment at (800) USC-CARE (800-872-2273). We also encourage you to consider MMR vaccination for children 12 months and older if you have not already done so.

For additional general and eye-related information regarding measles, please refer to the following offered by the Centers for Disease Control, World Health Organization and American Academy of Ophthalmology:

by Debbie Mitra