Ocular Implications of COVID-19 Infection and Vaccine-Related Adverse Events

Abstract

The COVID-19 pandemic, caused by SARS-CoV-2, has significantly impacted various organ systems, including the eyes. Initially considered a primarily respiratory disease, it is now evident that COVID-19 can induce a range of ocular symptoms. Recognizing these ocular manifestations is crucial for eye care practitioners as they can serve as early indicators of the disease. This review consolidates current evidence on the ocular effects of COVID-19, identifying manifestations such as conjunctivitis, scleritis, uveitis, and retinopathy. The increasing prevalence of these symptoms highlights the importance of thorough eye examinations and detailed patient histories in COVID-19 cases. Potential routes of viral entry into ocular tissues and the underlying mechanisms, including direct infection, immune responses, and vascular involvement, are explored. Additionally, this review addresses ocular side effects associated with COVID-19 vaccines, such as corneal graft rejection, uveitis, and retinal issues. These findings emphasize the need for ongoing surveillance and research to ensure vaccine safety.

Keywords: COVID-19; SARS-CoV-2; adaptive immune response; ocular immunity; ocular inflammation; side effects; vaccination.

Figure 1

Viral entry mechanism of SARS-CoV-2 and subsequent immune response dysregulation leading to COVID-19 ocular manifestations. (ACE: Angiotensin-Converting Enzyme; IL-17: Interleukin-17; Th17: T-helper 17 cells; Th1: T-helper 1 cells; IL-6: Interleukin-6; IL-1β: Interleukin-1β; TNF-α: Tumor Necrosis Factor-α; IFN-γ: Interferon-γ; IL-10: Interleukin-10). (Created with Biorender.com).