Ocular Adverse Events Following COVID-19 Vaccination: Rare but Important

Highlights

This literature review provides a summary of the adverse ocular sequelae of COVID-19 vaccines. The authors reported that uveitis and other ocular inflammations, acute corneal graft rejection, herpetic eye disease, anterior segment conditions, retinal conditions, optic neuropathies, and other ophthalmic conditions were associated with antiviral vaccination. COVID-19.
Despite the very rare occurrence of adverse ocular events following COVID-19 vaccination, the authors concluded that the benefits "overwhelmingly" outweigh these risks.

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 led to the devastating coronavirus disease 2019 (COVID-19) pandemic, which has become one of the largest global threats to the health to date. Nearly 220 million people have been infected worldwide as of the end of August 2021, claiming more than 4.5 million lives.

However, the isolation of the SARS-CoV-2 virus and the subsequent publication of its genome sequence in January 2020 triggered an unprecedented global response towards the accelerated development of preventive vaccine candidates and mobilized multinational collaborative efforts between pharmaceutical corporations, academic institutions, and government agencies.

The accelerated process culminated in the emergency use authorization of two recombinant mRNA vaccines (Pfizer/BioNTech BNT162b2 and Moderna mRNA-1273) by the United States Food and Drug Administration (FDA) in December 2020.6 Several others immunizations, including two of the adenovirus vector-based vaccines (AstraZeneca ChAdOx1 nCoV-19 and Janssen Ad26.COV2.S), have subsequently been approved worldwide and more than 5.3 billion doses have been administered to date vaccination against COVID-19 around the world.

Goals

To summarize the current evidence on ocular adverse events associated with the COVID-19 vaccine.

Design

Review of narrative literature.

Methods

The literature search was conducted in August 2021 using four electronic databases (MEDLINE, EMBASE, PubMed, and Cochrane Database of Systematic Reviews), and population-based pharmacovigilance surveillance data were retrieved from all participating government agencies. in the World Health Organization (WHO) Program for International Drug Monitoring with publicly available online adverse event databases in English.

Results

A small number of case reports have documented flares of uveitis and acute corneal graft rejection occurring within the first three weeks after immunization, while isolated cases of optic neuropathies, retinal conditions, scleritis have also been highlighted. and herpetic eye disease.

However, data from population-based pharmacovigilance surveillance systems would suggest that the prevalence of ocular adverse events associated with vaccination is very rare.

Conclusions

In conclusion, there has been limited research evaluating potential ocular adverse effects of COVID-19 vaccines. A small number of case reports have documented the development of uveitis flares and acute corneal graft rejection within the first three weeks after immunization.

In addition, rare cases of post-vaccination optic neuropathies, retinal conditions, scleritis and herpetic eye disease have also been highlighted, although it is recognized that causality and direct association cannot be inferred from isolated cases.

Overall, data from population-based pharmacovigilance reporting systems would suggest that ocular side effects are very rare following COVID-19 vaccination, and there is no substantial evidence to counteract the overwhelming benefits of immunization. in patients with pre-existing ophthalmic conditions.

Final message

Ocular adverse events associated with vaccination are rare, and there is currently no substantial evidence to offset the overwhelming benefits of COVID-19 immunization in patients with pre-existing ophthalmic conditions.

Ocular Adverse Events Following COVID-19 Vaccination: Rare but Important

Ocular adverse events associated with COVID-19 vaccination are rare but clinically significant, emphasizing the need for vigilance and reporting of such events to ensure timely recognition and management.