Resurgence of measles in Vietnam leading to acute keratitis in unvaccinated adults: A three-case series.

Purpose: To report three cases of rubeola keratitis secondary to measles in unvaccinated adults. Methods: We conducted a case series involving three unvaccinated adults admitted to the Department of Infectious Diseases during the mid-2025 nationwide measles outbreak in Vietnam. The diagnosis of measles was confirmed by positive measles-specific IgM. All patients were subsequently referred to the Ophthalmology Department due to acute bilateral ocular pain and redness. Slit-lamp biomicroscopy revealed keratitis with lesions localized centrally and confined to the epithelium and subepithelium. While systemic complications were managed by infectious disease specialists, ocular treatment consisted of supportive therapy with topical antibiotics and artificial tears. Results: All patients underwent weekly ophthalmic evaluations until the complete resolution of corneal epithelial erosions. Subsequently, monthly follow-up visits were maintained for six months to monitor for the potential development of post-measles dry eye syndrome and to ensure the absence of severe ocular complications. Overall, all patients achieved favorable outcomes. Ocular irritation and conjunctival hyperemia decreased within one week of treatment. Visual acuity improved progressively, and slit-lamp examination confirmed the resolution of corneal epithelial lesions. No sight-threatening complications, such as corneal ulceration or perforation, were observed during follow-up. Conclusion: These three cases highlight the clinical presentation of rubeola keratitis. Although all patients achieved favorable outcomes, adequate vaccination coverage remains essential to prevent future measles outbreaks.