Relapsed Disciform Stromal Herpetic Keratitis and mRNA COVID-19 Vaccination

Dear Editor,

We would like to share ideas on “Relapsed disciform stromal herpetic keratitis following mRNA COVID-19 vaccination [1].” We agree that the patient has relapsed disciform stromal herpetic keratitis. However, a causal interrelationship with coronavirus disease 2019 (COVID-19) vaccination remains an issue for fur ther studies. COVID-19 vaccine might cause ocular adverse effects and herpetic keratitis might be a clinical problem following COVID-19 vaccination. Basically, immunological abnormality induced by vaccine might be a trigger factor for this adverse event. However, no data on abnormal immune parameter is available for finalized conclusion. For an eye complication after COVID-19 vaccination, it might be due to immunepathology, coincidence, or other pathophysiological process [2]. For a case with possibility of herpetic reactivation, other lesions at patients might also occur and it is useful to have a complete body examination of the patient. Finally, a medical disorder might concurrently occur after COVID-19 vaccination. For example, dengue is reported in vaccine recipient [3] and stromal keratitis is also a possible rare clinical problem induced by dengue [4].