The author of this article is Dr. Vandana Jain, Regional Head – Clinical Services, Dr Agarwals Eye Hospital, Vashi

As measles infections rise unhindered in Maharashtra, it is very important to understand the effect of the disease on the eyes. Measles is a disease that needs to be taken very seriously because its impact on the eyes can be very serious if ignored. Measles is re-emerging as a threat to children in both the developing and developed world, with almost 30K to 50K cases of blindness being reported because of measles globally. Every year, it affects children who are malnourished and belong to the underprivileged socio-economic strata of society. Also, those children who have not been vaccinated against measles are especially vulnerable to the disease and the associated eye problems.

Eye problems due to measles

There are various ways that measles can impact the eye; the most common of those is conjunctivitis, also called “red eye,” which is usually visible as redness and watering of the eye and affects a lot of patients who suffer from measles. Conjunctivitis usually develops very early in the disease, along with fever, cough, and other symptoms. In fact, conjunctivitis often occurs even before the rash that develops in measles patients, so sometimes conjunctivitis is the first sign that a doctor can see before the actual rashes, which are a diagnostic symptom of measles.

The other way measles can impact the eye, which is less common compared to conjunctivitis, is through keratitis, which is basically an infection of the cornea, the front transparent part of the eye. In keratitis, the symptoms can be much more serious, and the consequences can also be far more dangerous. Symptoms can include eye redness, extreme sensitivity to light, watering, and a feeling of a foreign body sensation in the eyes. It is treated usually with eye drops, however, if keratitis leads to scarring, it can lead to some permanent reduction in vision.

Measles can also lead to corneal ulcers, which are ulcerations of the cornea. A lot of times, these ulcers appear as white dots on the cornea and is usually treated with various eye drops. Often, when these ulcers heal, they leave a scar on the cornea and lead to a permanent reduction of vision.

Other dangerous but rare impact of measles on the eye is retinopathy, where the virus can cause the destruction of the retina and it usually causes temporary vision loss, but in very rare case it can even lead to a permanent vision impairment.

Optic neuritis is another rare but dangerous impact of measles on the eye, in which the optic nerve gets inflamed. The work of the optic nerve is to send signals from the eye to the brain, and if something happens to optic nerve then we can’t see. Optic neuritis can cause permanent vision loss. However, if identified well in time, children can be treated with suitable medicines, and the condition can be reversed. 

When Should You Visit an Eye Doctor?

Any child with measles who has an eye problem should be treated by an ophthalmologist immediately. Parents should especially watch out for any kind of red eye or light sensitivity that the child may complain of or experience.  The eye should be checked thoroughly, including the cornea and retina. Also, these children should be given doses of vitamin A in consultation with a pediatrician, depending on their age bracket.  

Precautions

Measles as we know, is a highly contagious disease, if there are other children in the house then parents should be careful, and they should you keep their children isolated to the extent possible. Also, the child should not be sent to school as it can impact other children. Parents should watch out for any eye related symptoms, specifically in the early stages, like red eye, watering, light sensitivity, etc., as it could indicate an early sign of eye problems due to measles. If the child complains of any of these things, then the parents should immediately take the child to the eye doctor so that it can be thoroughly evaluated.

Treatments for Measles-Related Eye Problems

The treatment for measles mainly pertains to the management of symptoms only, as there are no antivirals or medicines for its cure. For eye problems related to measles, like in the case of conjunctivitis and keratitis, the treatment mainly pertains to what is needed to suppress and cure the inflammation faster.  The same process happens for retinopathy and optic neuritis, where the treatment is based on management and cure of the condition with the help of topical treatment, and in some cases, a form of systemic treatment may also be used to reduce the inflammation of the retina and the optic nerve