Ocular Adverse Events After COVID-19 Vaccination

ABSTRACT

Purpose

The COVID-19 pandemic has galvanized the development of new vaccines at an unprecedented pace. Since the widespread implementation of vaccination campaigns, reports of ocular adverse effects after COVID-19 vaccinations have emerged. This review summarizes ocular adverse effects possibly associated with COVID-19 vaccination, and discusses their clinical characteristics and management.

Methods

Narrative Literature Review.

Results

Ocular adverse effects of COVID-19 vaccinations include facial nerve palsy, abducens nerve palsy, acute macular neuroretinopathy, central serous retinopathy, thrombosis, uveitis, multiple evanescent white dot syndrome, Vogt-Koyanagi-Harada disease reactivation, and new-onset Graves’ Disease. Studies in current literature are primarily retrospective case series or isolated case reports – these are inherently weak in establishing association or causality. Nevertheless, the described presentations resemble the reported ocular manifestations of the COVID-19 disease itself. Hence, we hypothesize that the human body’s immune response to COVID-19 vaccinations may be involved in the pathogenesis of the ocular adverse effects post-COVID-19 vaccination.

Conclusion

Ophthalmologists and generalists should be aware of the possible, albeit rare, ocular adverse effects after COVID-19 vaccination.

KEYWORDS:

• COVID-19
• vaccination
• ocular inflammation
• adverse effects
• uveitis

Author contributions

All authors contributed to the intellectual development of this paper. NXL and RA conceived and planned the review. NXL, BKB, MDS, and RA wrote the manuscript. NXL and BKB performed the literature review. NXL, BKB, IT, SLH, MT, MZ, SPC, VG, CP, MDS, and RA contributed to interpreting the results and provided critical feedback to the manuscript. The final version of the paper has been seen and approved by all authors.

Declaration of interest

NXL, BKB, IT, SLH, MT, MZ, SPC, VG, CP, and MDS report no conflicts of interest, financial or propriety, in the subject matter or materials discussed in this manuscript. RA is supported by a grant from the National Medical Research Council (NMRC), Singapore, for the Clinician Scientist Award (CSA) from 2020-2023. He has not received funding for his work in this publication.