ABSTRACT
Purpose: To highlight the considerations in clinical diagnosis and management of ophthalmic vein thrombosis through a challenging case of asymptomatic posttraumatic bilateral superior ophthalmic and cavernous sinus thrombosis. Method(s): A review of electronic medical records. Result(s): A 54-year-old female with no significant past medical history presented to a tertiary trauma and referral hospital two hours after falling from a ladder and sustaining significant head and torso polytrauma. She had a second dose of BNT162b2 COVID-19 mRNA vaccination two weeks earlier. Contrast computed tomography imaging confirmed the presence of bilateral superior and inferior ophthalmic vein thrombi, and suspected cavernous sinus thrombi without carotid-cavernous fistula. The patient's presentation occurred in the absence of any neurological or ophthalmic signs or symptoms, and her visual acuity remained normal throughout follow-up. A serological inflammatory, infectious, and thrombotic screen was negative. Repeat computed tomography imaging demonstrated successful resolution of all thrombi following treatment with systemic anticoagulation. Conclusion(s): This unusual case of bilateral ophthalmic vein thrombi highlights a challenging diagnosis that should not be overlooked despite a normal neurological and ophthalmic examination. Although the cause of SOVT was likely post-traumatic, contribution from recent nVoC-19 vaccination was investigated.