We present a case of a 37-year-old healthy man who developed acute anterior uveitis after receiving the first and second doses of the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine. To the best of our knowledge, this is the first report of a recurring incidence of ocular side effects associated with COVID-19 immunization. Based on the timing of the start of symptoms with the first and second vaccinations, the absence of prior medical conditions, and unremarkable investigations, we believe that the patient's anterior uveitis may have been induced by the vaccine itself. This case suggests that vaccination could be a risk factor in uveitis development and recurrence following redosing. As a result, we recommend that ophthalmologists investigate the recent immunization status in each case of uveitis with a temporal association with COVID-19 vaccine administration and record these cases to improve the quality of data tracking of potential adverse responses to vaccines.
Purpose:To report the incidence of endophthalmitis, the clinical and microbiological aspects, after intravitreal (IVT) injection of anti-vascular endothelial growth factor.Methods:A chart review was performed of patients diagnosed with endophthalmitis after receiving IVT injections of bevacizumab (Avastin) and ranibizumab (Lucentis) presenting to King Khaled Eye Specialist Hospital (KKESH) from May 2006 to December 2012. Endophthalmitis was diagnosed clinically as an intraocular infection with vitreous involvement that required treatment with IVT antibiotics or had undergone pars plana vitrectomy (PPV) to remove the suspected microorganism. Main outcome measures were the incidence of endophthalmitis and the clinical and microbiological features.Results:Seven cases of endophthalmitis were identified, there was 1 (0.004%) case of endophthalmitis of 22674 IVT injections performed at KKESH. All cases were after IVT bevacizumab. Three (42.85%) cases were culture-positive and caused by Staphylococcus epidermidis. The initial management was vitreous tap and IVT injection of antibiotics followed by PPV in 6 (85.7%) cases. One (14.3%) case underwent evisceration. Visual acuity improved at last visit in only 2 (28.6%) cases. The rate of endophthalmitis was 0.0004% for bevacizumab.Conclusions:The rate of endophthalmitis after IVT bevacizumab and ranibizumab was very low. We recommend following a standardized injection protocol, adherence to sterile techniques, and proper patient follow-up are determinant factors for low incidence rates. In addition, endophthalmitis after IVT bevacizumab and ranibizumab have poor visual outcomes despite prompt treatment.
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