Posted on April 30, 2017
Vaccines, Rubella & Kids' Eyes
By: Jeffrey Colburn, MD
There is much popular debate currently regarding childhood vaccinations. This month the American Academy of Pediatrics has been focusing on the reasons for and importance of continuing vaccination efforts. We know that some of our audience may have concerns about vaccines. Our page is not the place to debate vaccination, but we would like to provide you with information regarding the impact of vaccination on pediatric ophthalmology. This is most distinctly seen when considering Rubella.
Most of our generation of pediatric ophthalmologists in the United States have not seen cataracts and other eye disease related to Rubella, but it is well documented in our textbooks. Also known as "German Measles", Rubella is a viral illness that was epidemic in the United States up through the 1960's. In the Rubella epidemic of 1964 alone, it was estimated that 30,000 children were born affected by the disease. Rubella is actually a fairly mild viral illness. However, the problem comes when women are infected during pregnancy. The intrauterine infection leads to "Congenital Rubella Syndrome" which can cause numerous systemic abnormalities including hearing loss, mental retardation, congenital heart defects, enlarged liver and spleen, among other things. With regards to the eye, Rubella will cause congenital cataracts in 20-30% of infected babies. Retinal changes, glaucoma, and corneal inflammation can also occur. Even with improved pediatric cataract surgery techniques, these children usually still end up with poor vision in the long term. Since the onset of the Rubella vaccine in 1969, congenital Rubella and the associated eye abnormalities have become very rare in developed countries. But this still remains a big issue in developing nations without consistent vaccination programs.
We are glad that we don't see children here at this point in history with severe life-long vision complications from congenital Rubella. Hopefully it stays that way.