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. 2023 Aug;31(6):1169-1174.
doi: 10.1080/09273948.2022.2133730. Epub 2022 Nov 7.

Reports of New and Recurrent Keratitis following mRNA-based COVID-19 Vaccination

Paras P Shah  1 , Yoav Glidai  2 , Richard Braunstein  1   2 , Matthew Gorski  1   2 , Jung Lee  1   2 , Farihah Anwar  1   2 , Amelia Schrier  1   2 , Jules Winokur  1   2 , Anne S Steiner  1   2
Affiliations

Reports of New and Recurrent Keratitis following mRNA-based COVID-19 Vaccination

Paras P Shah et al. Ocul Immunol Inflamm. 2023 Aug.

Abstract

Purpose: As ophthalmic side effects of messenger RNA (mRNA)-based COVID-19 vaccination are not well understood, it is crucial to document and report such instances should they occur.

Methods: In this observational case series, we report nine patients (55.6% male, mean age 58.9) who received either the BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) COVID-19 vaccinations from January to June of 2021, and presented with symptoms of keratitis within 14 days. All patients underwent slit-lamp examination and histories were taken.

Results: Most subjects (66.7%) had a history of corneal inflammatory diseases and resolved under antiviral and/or steroidal treatment. Patients who reported symptoms after their second vaccine dose presented earlier than those who reported symptoms after the first dose (mean 4.4 days vs 10.5 days, respectively).

Conclusions: The immunological reaction following mRNA-based COVID-19 vaccinations may trigger new-onset or reactivation of keratitis, though causality cannot be proven. Despite its rarity, clinicians should be aware of this possible complication and be prepared to treat.

Keywords: COVID-19; Cornea; inflammation; keratitis; vaccine.

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