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. 2022 Sep 19;10(9):1558.
doi: 10.3390/vaccines10091558.

Diplopia, COVID-19 and Vaccination: Results from a Cross-Sectional Study in Croatia

Jelena Škunca Herman  1 , Goran Marić  1 , Maja Malenica Ravlić  1 , Lana Knežević  1 , Ivan Jerković  1 , Ena Sušić  1 , Vedrana Marić  2 , Ivanka Petric Vicković  1 , Zoran Vatavuk  1 , Ozren Polašek  3   4
Affiliations

Diplopia, COVID-19 and Vaccination: Results from a Cross-Sectional Study in Croatia

Jelena Škunca Herman et al. Vaccines (Basel). .

Abstract

The aim of this study was to explore diplopia as a symptom of undetected COVID-19 infection or as a possible side effect of COVID-19 vaccination. We examined 380 patients with diplopia admitted to the Department of Ophthalmology of the University Hospital Centre Sestre milosrdnice in Zagreb, Croatia, from July 2020 to June 2022. After excluding patients with confirmed organic underlying diplopia causes or monocular diplopia, we linked the patient information with the national COVID-19 and vaccination registries. Among the 91 patients included in this study, previously undetected COVID-19 infection as the possible cause of diplopia was confirmed in five of them (5.5%). An additional nine patients (9.9%) were vaccinated within one month from the onset of their symptoms, while the remaining 77 had neither and were therefore considered as controls. The breakdown according to the mechanism of diplopia showed no substantial difference between the vaccinated patients and the controls. We detected marginally insignificant excess abducens nerve affection in the COVID-positive group compared with that in the controls (p = 0.051). Post-vaccination diplopia was equally common in patients who received vector-based or RNA-based vaccines (21.4 vs. 16.7%; p = 0.694). COVID-19 testing should be performed for all cases of otherwise unexplained diplopia. The risk of post-vaccination diplopia was similar in both types of vaccines administered, suggesting a lack of evidence linking specific vaccine types to diplopia.

Keywords: COVID-19; diplopia; risk; vaccine.

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Conflict of interest statement

OP is a scientific advisor to the Government of the Republic of Croatia for COVID-19 response, which had no influence in the decision to prepare the manuscript, its preparation or the selection of the journal where the manuscript would be submitted. The remaining authors declare that the study was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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