Acute Unilateral Central Serous Chorioretinopathy after Immunization with Pfizer-BioNTech COVID-19 Vaccine: A Case Report and Literature Review.

INTRODUCTION: A 43-year-old Caucasian male presented to our ophthalmology clinic with blurry vision and metamorphopsia in his right eye, 24 hours after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine. METHODS: Clinical examination and imaging tests were consistent with acute unilateral central serous chorioretinopathy (CSCR) that completely resolved after 2 months without any treatment. He had no significant ophthalmic or medical history. He also lacked the classical risk factors for CSCR such as recent psychosocial stressors, Type-A personality traits, history of exogenous steroid use, connective tissue disorders and obstructive sleep apnea. RESULTS: This appears to be only the second reported case of CSCR, temporally associated with a recombinant COVID-19 mRNA vaccine. We also present a summary of published reports demonstrating intraocular complications associated with the novel recombinant COVID-19 mRNA vaccines. CONCLUSION: Findings in this report should not deter COVID-19 vaccinations given the rarity of aforementioned ocular complications and the greater benefit of protection from COVID-19 infection. Medical practitioners, however, should remain mindful of potential ocular complications, given the greater likelihood of occurrence with increasing vaccination booster rates.

Chronic lymphedema of the eyelid: case series.

PURPOSE: To evaluate the clinical features, management and outcomes of treatment of chronic lymphedema of the eyelid in a tertiary referral setting. DESIGN: Retrospective case series. PARTICIPANTS: 15 patients referred to the authors with unilateral or bilateral eyelid swelling of greater than 3 months duration. MAIN OUTCOME MEASURES: Clinical features, patient management, response to treatment. RESULTS: Chronic eyelid lymphedema was associated with acne rosacea in 9 patients, radiotherapy in 1 patient, trauma in 1 patient and post-vitrectomy silicone oil leak in 1 patient. In the remaining 4 patients no associated condition or factor was identified. Surgical debulking was performed in 9 cases with improvement in all cases and no complications. CONCLUSION: Chronic eyelid lymphedema is a rare condition most commonly associated with rosacea. In our experience, surgical resection of involved subcutaneous tissue was helpful.

Porous orbital implants in enucleation: a systematic review.

Orbital implants have been used for cosmesis following surgical removal of the eyeball, or enucleation, for over a century. Implant design has progressed significantly in recent years with the use of porous devices, with the theoretical advantages of reduced complications and improved cosmesis. However, in some cases the theoretical benefits have not fully translated into clinical results. In this article the use of orbital implants in enucleation, with a particular focus on the newer porous biomaterials that have gained prominence over the last 15 years, is reviewed. Specific factors identified as affecting the performance of porous orbital implants include the material used, pore size, and morphology. Mechanical factors have received little consideration in the past and may form a basis for the use of higher compliance porous materials in the future. Of the porous materials in use, current clinical evidence is not sufficient to suggest either that porous implants are superior to non-porous implants, or that one material is more suited to the application than another. Future developments in this field require randomized controlled clinical trials with extensive follow-up as complications may not become evident until over 5 years post-implantation.

Role of topical chemotherapy for primary acquired melanosis and malignant melanoma of the conjunctiva and cornea: review of the evidence and recommendations for treatment.

Surgical excision with cryotherapy is a well-established treatment option for malignant melanoma or primary acquired melanosis (PAM) with atypia of the conjunctiva and cornea. Topical chemotherapeutic agents such as mitomycin C (MMC) however, are increasingly finding use in clinical practice. A search was performed of Medline and Pubmed databases for English language articles from 1980 to the present in this field. Relevant studies were reviewed with regards to treatment regimen, rates of recurrence and metastasis, side effect profile and length of follow up. A total of 22 and 16 unique cases of biopsy proven PAM with atypia and malignant melanoma, respectively, treated with topical MMC were identified. Topical MMC was well tolerated and shows considerable promise, particularly in the treatment of diffuse PAM with atypia. However, long-term data are lacking and further studies are required.

Blue filter discs and nasal endoscopic visualization of fluorescein lacrimal drainage.

For the lacrimal surgeon, fluorescein instilled in the palpebral aperture, and combined with the use of blue filters, can assist office assessment of lacrimal drainage by nasal endoscopy. The fabrication of a separate blue filter attachment for nasal endoscopes, however, is expensive. Inexpensive, heat-stable blue filter discs were sourced from a manufacturer of fiberoptic instruments in Sydney, Australia. These discs can be made in various sizes suitable for standard battery-powered, portable nasal endoscopes. The discs were used in the postoperative assessment of a patient with lacrimal drainage-related pathology. They were easy to use and provided suitable wavelength transmission for improved assessment of fluorescein drainage through the lacrimal system.