Prior Ocular Disease may Exacerbate Shingles Recurrence Risk

HZO is a viral and often sight-threatening disease that affects the ophthalmic branch of the trigeminal nerve, causing large and painful rashes around the forehead and eyelids. Photo: Alan Kabat, OD. Click image to enlarge. A study presented yesterday at the ARVO annual meeting in Denver found that the herpes zoster ophthalmicus (HZO) vaccination was associated with a short-term increased risk of recurrent HZO within 56 days in patients with prior disease.This retrospective cohort study evaluated patients aged 50 and older using data obtained from a large integrated healthcare system. Patients had a history of HZO between 2010 and 2023 and later received either a live zoster vaccine or recombinant zoster vaccine. A total of 10,018 patients were identified with HZO, and 2,900 among them went on to receive vaccination after their initial diagnosis. The study used a self-controlled risk interval design, meaning that each patient served as their own control. Researchers compared recurrence rates during a defined risk window of days one to 56 after vaccination with a later control window of days 57 to 112.In their ARVO abstract, researchers described the recurrence of HZO as a “primary outcome,” defining it as “active disease requiring new or escalated treatment.” They identified 38 recurrence cases within 112 days following vaccination. Among those who experienced recurrence, 89% “had pre-existing ocular involvement prior to vaccination, compared with 119 (42%) in patients who did not recur following vaccination,” a statistically significant difference. The median time from initial HZO diagnosis to first vaccination was 309 days, with a range of 185 to 625 days in the recurrence group.These findings indicate that individuals with prior ocular involvement may be at higher risk for recurrence shortly after receiving a shingles vaccine, according to the researchers’ abstract.Original abstract ©2026 Association for Research in Vision and Ophthalmology.Click here for the journal source. Qian Y, Fink D, Fireman B, et al. Risk of herpes zoster ophthalmicus recurrence immediately following zoster vaccination. ARVO 2026 annual meeting. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.