ABSTRACT
Purpose: To report a novel case of Urrets-Zavalia syndrome (UZS). Observation: A 59-year-old man underwent removal of a dislocated intraocular lens and placement of a scleral-sutured intraocular lens. After surgery, the pupil in the operative eye was dilated, fixed, and unresponsive to constricting drops. Conclusion: This case expands the known etiology of UZS. Possible preventative measures may include pre-operative screening for plateau iris and intra-operative use of iris hooks instead of pharmacological dilation.
ABSTRACT
PURPOSE: Coronavirus disease 2019 has had a wide-ranging public health impact, contributing to at least five million deaths globally at the time of this report. Although thromboembolic events following coronavirus disease 2019 vaccination have been an ongoing concern, only a limited number of ophthalmic manifestations have been reported to date. METHODS: A detailed history, hypercoagulable workup, best-corrected visual acuity (BCVA), Humphrey visual field, dilated fundus examination, and multimodal imaging including optical coherence tomography, fundus fluorescein angiography, and fundus photography were obtained. RESULTS: A 27-year-old woman was diagnosed with central retinal vein occlusion a few days after her first dose of the BNT162b2 (Pfizer-BioNTech) coronavirus disease 2019 vaccine. Detailed elicitation of her history and a full hypercoagulable workup did not reveal any primary risk factors that could have explained her disease process. After the patient received the second dose, her symptoms deteriorated significantly and worsening peripapillary hemorrhage were seen on dilated fundus examination. The patient was treated with intravitreal injections of ranibizumab and followed closely, which showed improvement in her central retinal vein occlusion. CONCLUSION: Given the chronology of the patient's condition, it is believed that the central retinal vein occlusion that occurred as a result of the first dose was exacerbated by an intense immunological reaction after the second dose. The severity of this complication, despite its rarity, must be emphasized and weighed in but should not preclude the extensive benefits of vaccination.
Subject(s)
COVID-19 Vaccines , COVID-19 , Retinal Vein Occlusion , Adult , Female , Humans , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Fluorescein Angiography , Intravitreal Injections , Ranibizumab , Retinal Vein Occlusion/diagnosis , Tomography, Optical CoherenceABSTRACT
We report the case of a 64-year-old male who developed sudden onset of bilateral no light perception vision and bilateral total internal ophthalmoplegia after pituitary apoplexy. He underwent transsphenoidal pituitary decompression. Four months after the surgery, the patient recovered excellent functional vision (20/25) in one eye, though with significant residual visual field loss. He regained full extraocular motility bilaterally.
ABSTRACT
The COVID19 pandemic has had a significant public health impact globally, with inoculation now paramount in limiting the spread of the disease. Although the safety and efficacy profiles of COVID19 vaccines are well documented, it is upon the medical community to be aware of adverse effects to appropriately advise and treat patients. We report the case of a 39yearold female who was hospitalized with optic neuritis (ON) 1 week after her second dose of the PfizerBioNTech (BNT162b2) COVID19 vaccine. The patient did not have any significant medical history, including personal or familial history of multiple sclerosis or any other demyelinating disease, other than prior COVID19 infection. She had since made a full recovery and tested negative at the time of hospitalization for ON. Over the course of her admission, the patient's visual acuity (VA) deteriorated from 20/400 to no light perception. After methylprednisolone was ineffective, she was started on plasmapheresis (PLEX) therapy which resulted in mild improvement of VA. To our knowledge and after a thorough PubMed literature search, this is the first reported case of isolated ON associated with COVID19 vaccination.
