Unilateral Episcleritis Following COVID-19 Booster Vaccination of a Crohn’s Disease Patient: A Case Report and Review of the Literature

Abstract

Purpose

The Coronavirus Disease 2019 (COVID-19) pandemic spurred vaccine development and resulted in the development of the novel mRNA COVID-19 vaccine and with it, a growing public concern of vaccine side effects. There are reports of ocular inflammatory processes such as episcleritis being possible side effects of COVID-19 vaccination. Here we reported the first case of unilateral episcleritis in a Crohn’s disease patient following her third mRNA COVID-19 vaccination booster shot.

Patient and Methods

A 27-year-old female presented with a 1-day history of right eye redness, itching, and burning. Patient reported developing these symptoms within 3–4 hours after vaccination. Her past medical history was relevant for Crohn’s disease. Ophthalmic examination revealed right 2+ conjunctival injection that blanched with phenylephrine drops. Otherwise, her ophthalmic exam was unremarkable. The patient was started on artificial tears and ibuprofen 200 mg three times daily for one week. After one week all symptoms resolved, and ophthalmic examination was back to baseline.

Conclusion

This is the first case in the literature of ophthalmic side effects in a Crohn’s disease patient after the third mRNA COVID-19 booster. Patients with Crohn’s disease may respond differently to booster vaccination. This case report may help healthcare providers when counselling Crohn’s disease patients about future COVID-19 mRNA vaccine side effects.

Keywords:

• episcleritis
• Crohn’s disease
• case report
• COVID-19
• vaccine

Abbreviations

COVID-19, Coronavirus disease 2019; SARS-CoV2, severe acute respiratory syndrome coronavirus 2; BCG, bacille Calmette-Guerin; MMR, measles mumps and rubella; HPV, human papilloma virus; NSAIDs, non-steroidal anti-inflammatory drugs.

Data Sharing Statement

All data generated or analyzed during this study are included in this published article.

Ethics Approval and Consent to Participate

University Institutional Review Board approval was not obtained, as this is a single case report.

Consent for Publication

Written informed consent was obtained from the patient for publication and for use of data and images.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The authors received no specific funding for this work.