What does a measles outbreak mean for optometrists?

April 11, 2014
Be ready for ocular complications, and encourage immunizations

A resurgence of the measles infection has resulted in recent outbreaks in both California and New York—51 and 25 cases, respectively.

Though measles was declared "eliminated" from the United States in 2000, according to the Centers for Disease Control and Prevention , some experts blame the recent outbreaks on a growing number of parents who opt out of immunizations for their children.

Preparing doctors of optometry for a measles outbreak

The most common ocular complication associated with measles is bilateral non-purulent keratoconjunctivitis, says David Ardaya, O.D., member of the California Optometric Association (COA). This occurs in 60 to 75% of measles cases.

Rare but serious complications such as retinopathy can occur with measles, which may include disc and macular edema, hemorrhages and optic atrophy.

"Doctors who practice in measles hot spots should take the time to inquire about the patient's immunization status if any other signs are present," Dr. Ardaya says.

Doctors of optometry should also be on the lookout for common signs of measles, including high fever and white spots inside cheeks early in the condition. The typical rash appears about 14 days after the virus is contracted.

Doctors of optometry and their impact on immunizations

The World Health Organization's strategy to eliminate measles includes recommending that all unvaccinated children receive the Measles Containing Vaccine (MCV) between 9 and 12 months of age as part of routine health services.

A second dose of MCV is suggested at 15 to 18 months of age or at school entry, because a single dose MCV will leave people unprotected and will not prevent large outbreaks.

David Redman, O.D., COA Legislation-Regulation Committee chair, says doctors of optometry and other providers can help increase immunization rates.

"We believe every visit to a health care provider should be used as an opportunity to review adolescents' immunization histories and ensure that every adolescent is fully vaccinated," says Dr. Redman, who is also part of the AOA's Third Party Center executive committee.

The COA has even sponsored state Senate Bill 492, by Senator Ed Hernandez, which would authorize doctors of optometry to administer immunizations.

Dr. Ardaya, father of two, understands that some parents opt out of vaccinations for their children, but he believes "it is an irrefutable fact that vaccinations save lives and protect children."

"As physicians, we need to strongly encourage vaccinations," he says.

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