Age: 18.0
Sex: F
Vaccine: MENB, MENB
Symptoms: Loss of personal independence in daily activities, Mydriasis, Photophobia, Pupillary disorder, Syncope
Clinical narrative: This is a spontaneous report from a contactable consumer who reported on behalf of her daughter.  A 18-year-old female patient received TRUMENBA; lot # S50879 on 12Jun2018, at single dose, for immunization. Medical history included that she had been wearing contacts since around May2017 or Jun2017 approximately, she had been wearing also glasses for distance (started use around maybe 8th grade), Strep throat and sinus infection. Past drug history included previous amoxicillin/clavulanic acid (AUGMENTIN) therapy without any adverse event. Concomitant drug included amoxicillin/clavulanic acid (AUGMENTIN) twice a day, maybe about 5 days before vaccination with TRUMENBA (Jun2018), for about 10 days, for Strep throat and sinus infection. The patient developed anterior uveitis in both eyes on 16Jun2028 and synechiae in her right eye since an unspecified date in 2018, after vaccination. She was on corticosteroids drops but will be switched to oral medication for 2 years and stop the eye drops because they could damage the eye. Clinical course of the events included the following information. Approximately on 16Jun2018 the patient started having some eye issues, which was later diagnosed as anterior uveitis in both eyes, being worse in the right eye. She developed synechiae in her right eye. She was still receiving treatment for these conditions. Around 16Jun2018, the patient did not have red eyes or pain like caller has read about, but she did complain that her eyes felt funny and watery when she woke up in the morning. It did not look red or goopy, but then during the next week she was complaining that her vision was a little cloudy, or blurry. They thought maybe it was her contacts, or conjunctivitis, but they did not know. They had to wait a couple of days to go see the patient's Optometrist who, looking in her eye, could see white blood cells in there. The Optometrist initially told them to go straight to the Emergency Room but while they were on the way there the Optometrist called them back and told them to go to an Institute instead where they could see her right away, and specialized in uveitis. The patient was put on atropine eye drops that she was supposed to use in both eyes to dilate her eyes and keep them from sticking and scarring due to synechiae, which she was diagnosed with in her right eye. The synechiae did not completely go away, her pupil remained irregularly shaped in her right eye stuck in the lower corner because of the scarring on her cornea from the inflammation. She was on eye drops in both eyes all summer of 2018, even though her right eye was worse. She went back to college and had to follow up in a month down there. When she had her follow-up appointment they put her right back on atropine drops and she was seen again 2 weeks later, now the anterior uveitis was back in her left eye again. The patient went back to see the Doctor on 16Oct2018 and he wanted her to be on oral celecoxib (CELEBREX) for 2 years to try to stabilize her from the medication because the eye drops were not clearing the condition up all the way, and the corticosteroid eye drops can cause cataracts or glaucoma. Caller had read that Trumenba had Factor H binding protein that could potentially cause autoimmune disease. The patient has had other vaccines before, but she had never had these events occur before. It wasn't until they started doing research, and she mentioned that the patient had received the TRUMENBA vaccine that the doctor mentioned he had heard that vaccines could cause uveitis. The patient's conditions had quieted but it was not completely gone, the eye remained inflamed and the white blood cells attacking the inside of her eye. They tried to stop the eye drops because of the risk of damage to the eye from reaching a certain cumulative amount of drops. They were trying to taper off of the eye drops, which right now she was still using in both eyes. If Celebrex would have not work to stabilize her condition, and to prevent relapse, then she will have to be on steroids. Because she wore glasses and contacts she got her eyes checked and she had never had these events occur before. These events have made it hard for the patient to read and affected her near vision, when she already wore glasses for distance. She was having to walk around with just one eye open because of the right eye with the synechiae and her having one eye fully dilated and misshapen. She could not hardly read, had to close her eye to read her phone, or for studying and she had light sensitivity with the dilated eye. They did a whole bunch of blood work because uveitis could have been from Lyme disease, but she did not have any results or patterns to indicate autoimmune disease or Lyme disease, even though her ANA was slightly elevated, which she thought it was a 1:160 titer. The patient had to have an angio something or other where they put something in the veins in her eyeballs, and she fainted right there in the chair when they were trying to do that. They did other blood work, but she did not have further details on those results to provide at time of this report. She used generic of prednisolone (PRED FORTE) two 5mL bottles of eye drops for the inflammation. One guy thought difluprednate (DUREZOL) was better, so patient used the generic for the inflammation but was 200 dollars a bottle. One of the drops she was using was 8 drops a day. Caller clarified that she did not think the atropine eye drops had a quality issue, she explained evidently that it was extremely standard, common, for the conditions to not go away the first time they try to treat it. The events were resolving at the time of report. The patient was supposed to get the second dose of TRUMENBA in Dec2018, because it was required by the patient's college, but reporter did not want her to receive the second dose. It was unknown if she will get the second dose or not.