ABSTRACT
Purpose : With the recent emergence and worldwide distribution of COVID-19 vaccines, many side effects may be underreported and possibly unknown. Cases of vaccine-associated uveitis have been linked to almost all vaccines administered in the past, however, there is scarcity of literature providing insight into post COVID-19 vaccine associated uveitis / episcleritis. By documenting patients presenting with uveitis / episcleritis after the administration of mRNA Pfizer and Moderna vaccines, this case series significantly advances our current understanding of potential COVID-19 vaccine ocular complications. Methods : Patients with ocular symptoms consistent with uveitis / episcleritis within 15 days of the administration of the Pfizer or Moderna COVID-19 vaccine were included in this study. Ocular assessment included a Snellen best-corrected visual acuity (BCVA) converted to logMAR, intraocular pressure (IOP) with Goldmann Applanation Tonometry, pupil check, anterior and dilated posterior segment assessment with slit-lamp, and optical coherence tomography (OCT) imaging. Patients were anonymized and demographics including sex, race, age, and other necessary clinical data were recorded. Results : A total of 9 patients (6 female and 3 males) with a mean age of 42.9 (range, 19-83) were included. 7 patients received a Pfizer vaccine and 2 received a Moderna vaccine. 5 patients presented with symptoms after their first dose, 2 after their second dose, and 1 after both doses. The mean time of ocular symptoms post vaccine was 6.15 days (range, 1-14) and the mean BCVA was 0.657. Patients were diagnosed with bilateral anterior granulomatous uveitis (case 1), unilateral nongranulomatous anterior uveitis (case 2, 6-9), bilateral nongranulomatous anterior uveitis (case 3-4), and episcleritis (case 5). Case 1 and 9 have been highlighted and summarized in figure 1 and 2, respectively. Conclusions : The pathogenesis of vaccine induced uveitis is not properly understood, however, the outcomes of this case series aids in establishing a temporal association between the Pfizer and Moderna COVID-19 vaccines and the onset of uveitis / episcleritis. As the rate of COVID-19 vaccinations increase globally, it is imperative for physicians to be aware of the possible association and presentation of these ocular findings and diagnoses to effectively treat patients.