Bilateral non-arteritic posterior ischaemic optic neuropathy following COVID-19 vaccination.

We report a case of bilateral posterior ischaemic optic neuropathy, which followed vaccination with ChAdOx1 nCoV-19 for COVID-19 prophylaxis. A man in his early 60s was initially assessed for bilateral acute vision loss following 3 days of frontal headaches. The patient denied any other preceding visual concerns or symptoms of giant cell arteritis. The patient received his first dose of the ChAdOx1 nCoV-19 vaccination 10 days before the onset of his symptoms.At initial presentation, visual acuity was counting fingers bilaterally. Blood work found normal erythrocyte sedimentation rate (6 mm/hour) and C reactive protein (<5 mg/L) as well as a negative infectious and autoimmune serology. He was negative for COVID-19 with PCR testing. Diffusion-weighted MRI showed restricted diffusion along both optic nerves. After 5 months, the patient's visual acuity remained counting fingers bilaterally with pale optic nerves. Isolated bilateral posterior ischaemic optic neuropathy has not been reported in association with the ChAdOx1 nCoV-19 vaccine.

Preoperative Variables Associated with Surgical Outcome for the Correction of Exodeviation.

The success rate of exodeviation surgery in existing literature has been shown to be variable. This study sought to determine the success rate of surgery for exodeviation in Atlantic Canada and determine variables associated with surgical outcome. A retrospective chart review was performed, considering patients who had been assessed and surgically treated for exodeviation at the IWK Health Centre between 2011-2018. This study included 176 subjects, aged 1-75 years. Preoperative variables were compared between subjects with successful versus unsuccessful surgical outcomes, using the chi square, Fischer's exact test and binary logistic regression. A success rate of 43% was determined. Smaller preoperative deviation size at near and distance fixation, as well as the basic type classification were associated with successful operative outcome. Left eye acuity showed a statistically significant association with surgical success outcome. In conclusion, these findings compliment those of previous groups, suggesting exodeviation surgery outcome is variable. Our results add to a growing list of variables implicated in outcomes for these subjects. A smaller deviation preoperatively was associated with success in existing data and in this study, and these findings may suggest a potential role for basic subtype into future exodeviation literature.