Bilateral Panuveitis with Occlusive Vasculitis following Coronavirus Disease 2019 Vaccination

Purpose: To report a case of bilateral panuveitis and occlusive vasculitis following COVID-19 vaccination. Study design: Case report. Results: A 41-year-old otherwise healthy male presented with progressive vision loss and floaters starting 48 hours after a first dose of COVID-19 vaccine. Examination initially showed bilateral anterior uveitis, but this evolved into bilateral panuveitis with occlusive vasculitis despite topical corticosteroids over two weeks. The patient underwent extensive testing for other etiologies which were excluded. He was successfully treated with a gradual taper of topical and systemic corticosteroids leading to improvement of signs and symptoms. Follow-up is maintained for observation of avascular zones with possible neovascularization which could require laser as needed. Conclusions: The temporal association between vaccine and presentation makes this a plausible etiology. This remains a rare adverse event, but clinicians should be aware of this possibility to include it in their differential diagnosis when confronted with idiosyncratic ocular presentations.

Automated summary

This case report describes a patient who developed bilateral panuveitis and occlusive vasculitis following COVID-19 vaccination. The patient showed improvement with topical and systemic corticosteroid treatment. This report highlights the importance of considering vaccine adverse reactions in the differential diagnosis of ocular presentations.