1-year review: Ocular complications possible after COVID-19 vaccination
Click Here to Manage Email Alerts
Although relatively few, reports of adverse ocular events following COVID-19 vaccination may warrant caution or delay of boosters in lower-risk groups with active ophthalmic complications, according to research in Vaccines.
“A vital component of understanding the optimal clinical use of these vaccines is a thorough investigation of adverse events following vaccination,” Abid A. Haseeb, MD, of the department of ophthalmology and visual sciences at the University of Illinois at Chicago, and colleagues wrote. “To date, some limited reports and reviews have discussed ocular adverse events following COVID-19 vaccination, but a systematic review detailing these reports with manifestations and clinical courses as well as proposed mechanisms has yet to be published.”
Haseeb and colleagues searched PubMed for articles that reported adverse ocular manifestations following vaccination between December 2020 and December 2021. They collected 58 studies, of which 28 were case reports, 22 were letters to the editor, five were case series and three were photo essays.
Researchers then categorized the articles by adverse events (eyelid, orbital, corneal, uveitis, retinal, vascular, neuro-ophthalmological, ocular motility disorders and unspecified) and identified 94 patients with adverse events, 87 of whom had documented vaccine information. The most common vaccines were BNT162b2 mRNA SARS-CoV-2 (BioNTech/Pfizer), which was reported 55 times; AZD122 ChAdOx1 nCoV-19 (AstraZeneca), reported 20 times; and Moderna COVID-19, reported 6 times.
According to the review, adverse events reported after vaccination included eyelid (n = 2) and orbital (n = 3) manifestations, uveitis (n = 14), corneal (n = 11) and retinal (n = 12) manifestations, vascular events (n = 4), neuro-ophthalmological manifestations (n =4), gaze palsies (n = 7) and scleritis (n = 1).
However, with relatively low numbers of reports in each category, the authors recommended additional reports and clinical information to establish thorough guidelines and insights for care.
“Leading clinical bodies in ophthalmology have not provided official guidelines on the use of COVID-19 boosters in the setting of active ophthalmic complications, yet it is our belief that caution and delay may be warranted in lower-risk groups with active complications,” Haseeb and colleagues concluded. “Nevertheless, it is the opinion of the authors that vaccination is a vital public health tool in the management of the COVID-19 pandemic.”
Perspective
Back to Top
This comprehensive review of ocular complications following COVID-19 vaccination provides optometrists an overall picture of the different ocular structures that have been documented to be affected by the vaccines. Some of the major ocular structures that may be affected by the COVID-19 vaccine include: orbit, anterior segment, posterior segment and cranial nerves. The major limitations of this study are the lack of longitudinal data and the small sample size of the studies reviewed by the authors.
Despite these limitations, there seems to be a common thread connecting the different ocular complications: a pro-inflammatory response that the vaccine appears to trigger in the body. Therefore, optometrists should consult with the patient’s primary care physician and consider recommending low-risk patients with active inflammatory conditions to delay COVID-19 booster injections.
Collapse
Read more about
Click Here to Manage Email Alerts