Herpetic anterior uveitis following Pfizer-BioNTech coronavirus disease 2019 vaccine: two case reports

Abstract

Purpose: To describe two cases of herpetic anterior uveitis after inoculation of the first dose of Pfizer-BioNTech coronavirus disease 2019 vaccine.

Methods: Case 1: a healthy 92-year-old Caucasian woman developed symptomatic unilateral anterior uveitis for 3 days after Pfizer-BioNTech coronavirus disease 2019 vaccination (Pfizer Inc.). The episode fully resolved with topical and oral antiviral treatment. Case 2: a previously healthy 85-year-old Caucasian woman with left hemicranial signs of herpes zoster infection, associated with herpetic keratouveitis for 3 days after Pfizer-BioNTech coronavirus disease 2019 vaccination. Treatment with topical antibiotics and both oral and topical antiherpetic medication was administered, and she recovered successfully in 5 weeks.

Conclusion: Clinicians should be aware of the possibility of eye inflammation in the form of herpetic reactivation after coronavirus disease 2019 vaccination.

Keywords: COVID-19 vaccines; Herpes zoster; Inflammation; SARS-CoV2; Uveitis anterior.

Fig. 1

a Central and inferior positive fluorescein keratitis of dendritic morphology in the lower half of the cornea. b Image of the anterior ocular pole with corneal edema and mature brunescent cataract

Fig. 2

a Erythematous lesions in the left ophthalmic branch of the V cranial nerve associated with vesicles. b and c Mild conjunctival hyperemia and, in cornea, scattered epithelial lesions of small size with vesicular borders and fluorescein positivity