Cornea Transplants and COVID-19

What if I contract COVID-19?
While there is still much unknown about COVID-19, we do know that in some cases it can greatly increase inflammation in the body and the immune response can be significant. For that reason, if you contract the virus, you may need to consider additional steroids to protect your cornea transplant. 
If you contract COVID-19, and particularly if you have severe symptoms, you should consult your eye doctor to determine if increased steroid use is right for your individual case. Our current recommendation for COVID-19 positive cornea transplant recipients, who are on fluorometholone (FML) or another low dose steroid, is to switch to Pred forte® (a stronger steroid) four times per day for two weeks, unless you have experienced elevated eye pressure in the past or are currently taking Pred forte®. In that case your doctor may recommend you stay on your current steroid but increase your drop use per day.
If you have never had an increased pressure from steroids, the risk of developing complications from their increased use for a short period of time is small. It may keep your cornea graft safe while your overall health is recovering. For those who have had an increased pressure from topical steroids, please contact the doctor who manages your graft/pressure in the eye.
Data and treatment recommendations are rapidly changing with COVID-19. However considering past evidence, we believe a recommendation of increased steroid use for most COVID-19 positive transplant recipients is appropriate. Should you have any questions consult your doctor’s office or call Price Vision Group at 317-844-5533.
Should I receive the COVID-19 vaccine since I had a cornea transplant?
Vaccines stimulate the immune system to build antibodies against viruses. This process can cause your immune system to reject your donor cornea graft because it recognizes the tissue as foreign material. Cornea transplant recipients are prescribed corticosteroid eye drops to use long-term which keeps their immune system from recognizing the donor tissue as foreign and rejecting it.  According to Dr. Francis Price, founder of the CRFA, getting the flu or COVID-19 would cause a stronger immune response than the vaccines alone. The COVID-19 vaccine, for example, does not contain a live virus. Having a cornea transplant is not a reason to avoid receiving the flu or COVID-19 vaccines. 
Should I increase steroid use prior to the vaccine?
For full-thickness transplants we have long advocated for increasing steroids prior to and just after an influenza "flu" vaccine as it elevates the immune response. At this time, our current recommendation is to follow the same protocol for the COVID-19 vaccine. For COVID-19 and influenza vaccines, increase steroids to 4 times per day for two days before and two weeks after vaccine receipt.  We understand that COVID-19 vaccines may become available without two days' or more advanced notice. In that situation, increase steroids to 4 times per day beginning the day of vaccination and for two weeks after.
Know the signs of transplant rejection “R.S.V.P”
 If you experience any of the following, call your doctor’s office immediately:
·         Redness
·         Sensitivity to light
·         Vision – decreases in vision, especially if foggy or cloudy
·         Pain – discomfort, irritation or foreign body sensation
For more vaccine information:
We look forward to keeping you up to date as further information develops.