Age: 59.0
Sex: F
Vaccine: UNK, UNK, UNK, UNK, UNK, VARZOS
Symptoms: Palpitations, Vision blurred, Vitreous detachment
Clinical narrative: cataract; Opthalmic herpes zoster; condition aggravted; right eye is little blurry; Interference with activity of daily living; Necluer sclerotic cataract; Drug dose administration interval too long; This case was reported by a physician and described the occurrence of cataract in a 60-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   Co-suspect products included valaciclovir hydrochloride (Valtrex) unknown for ophthalmic herpes zoster.   The patient's past medical history included nerve compression, arm operation, cataract extraction (left eye), photophobia (right eye light sensitive and tearing), conjunctivitis, conjunctivitis, ex-smoker, ophthalmic zoster (had zoster with ophthalmic involvement, zoster conjuctivitis with redness on eyelid, pressure, eye pain and pulling around right eye. eyes got tired more than usual.), herpes zoster, double vision (brief episode of transient double vision), reading disorder (struggling to read), facial pain, hyponatremia and excessive drinking. Previously administered products included Shingrix with an associated reaction of ophthalmic herpes zoster (1st dose received on 31st August 2018, refer case US2020AMR013060 ), Erythromycin, Vigamox, Atropine, Cyclopegic, Trileptal, Zirgan, Cyclogel and Prednisolone. Concurrent medical conditions included post herpetic trigeminal neuralgia, corneal dystrophy, corneal guttata, headache (Nonitracable), temporal headache, palpitation, cataract extraction, intraocular lens implant, phacoemulsification, cataract (left eye), vitreous detachment and blurred vision.   In March 2019, the patient received the 2nd dose of Shingrix. On 5th July 2016, the patient started Valtrex (oral) 1000 mg twice daily (2000 mg daily). On 29th July 2016, the dose was changed to 1000 mg 3 times daily (3000 mg daily). On an unknown date, the dose was changed to 1000 mg once daily (1000 mg daily). On an unknown date, the dose was changed to 1000 mg 3 times daily (3000 mg daily). On an unknown date, the dose was changed to 1000 mg once daily (1000 mg daily). On an unknown date, less than 4 months after receiving Shingrix and unknown after starting Valtrex, the patient experienced cataract (serious criteria GSK medically significant), ophthalmic herpes zoster (serious criteria GSK medically significant), condition aggravated, blurred vision, activities of daily living impaired, nuclear cataract and drug dose administration interval too long. The patient was treated with anesthetic, nos (Anesthesia) and sedatives nos (Intravenous Sedation (Nos)). On 2nd July 2019, the outcome of the blurred vision and nuclear cataract were recovered/resolved. On 2nd September 2019, the outcome of the cataract was recovered/resolved. On an unknown date, the outcome of the ophthalmic herpes zoster and condition aggravated were recovered/resolved and the outcome of the activities of daily living impaired and drug dose administration interval too long were unknown.   It was unknown if the reporter considered the cataract, ophthalmic herpes zoster, condition aggravated, blurred vision, activities of daily living impaired and nuclear cataract to be related to Shingrix and Valtrex.  Additional details were provided as follows: The patient medical history includes, the patient had ulnar nerve compression and left arm surgery, had left eye cataract extraction,pseudophakia, post herpetic trigeminal neuralgia, anterio basement membrane dystrophy, corneal guttata. The patient had nonintracable headache, heart palpitation as a current medical condition. The patient had temporal pain, photophobia of right eye, zoster conjuctivitis  as a historical condition. The patient had double vision, reading difficulty, facial pain, hyponatremia and excessive drinking as a historical condition and cataract of left eye and vitreous detachment of right eye as a current condition. The patient had historical condition of former smoker. The patient had historical condition of  zoster with ophthalmic involvement. The patient received erythromycin, vigamox, cyclopegic, trileptal, atropine, zirgan,cyclogel and prednisolone as a historical medication. On 7th March 2019, in left eye, onset was gradual and vision was blurred, severity was moderate and occurred constantaly. The patient stated that, vision was getting worse and glare problem at night on 7th March 2019. On 26th June 2019, the patient had phacoemulsification with posterior chamber intraocular lens implant in left eye. The patient had visual significant cataract in the operative eye which interference with activity of daily living. The patient also had significant nuclear sclerotic cataract in left eye. On 26th June 2019, the reporter reported that, the patient had no discomfort or pain, selpt well and no complications. On 2nd July 2019, the patient stated that, vision was great and no problem. and planned to decrease doseof Valtrex to daily on saturday. On 9th January 2020, 6th months followup cataract right eye, the patient stated that, vision was doing well overall, right eye little blurry than before and zoster with ophthalmic involvement. The patient continued with 1 gram of Valtrex daily and the patient was off for gabapentin.