Reports of New and Recurrent Keratitis following mRNA-based COVID-19 Vaccination

ABSTRACT

Purpose

As ophthalmic side effects of messenger RNA (mRNA)-based COVID-19 vaccination are not well understood, it is crucial to document and report such instances should they occur.

Methods

In this observational case series, we report nine patients (55.6% male, mean age 58.9) who received either the BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) COVID-19 vaccinations from January to June of 2021, and presented with symptoms of keratitis within 14 days. All patients underwent slit-lamp examination and histories were taken.

Results

Most subjects (66.7%) had a history of corneal inflammatory diseases and resolved under antiviral and/or steroidal treatment. Patients who reported symptoms after their second vaccine dose presented earlier than those who reported symptoms after the first dose (mean 4.4 days vs 10.5 days, respectively).

Conclusions

The immunological reaction following mRNA-based COVID-19 vaccinations may trigger new-onset or reactivation of keratitis, though causality cannot be proven. Despite its rarity, clinicians should be aware of this possible complication and be prepared to treat.

KEYWORDS:

• Cornea
• COVID-19
• inflammation
• keratitis
• vaccine

Disclosure statement

No potential conflict of interest was reported by the author(s).

IRB statement

The Institutional Review Board (IRB) of Northwell Health approved the study protocol.

Patient consent

Consent for publication was obtained from each participant.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.