Bilateral anterior non-necrotising scleritis, anterior uveitis, and unilateral facial nerve palsy in paediatric inflammatory multisystem syndrome temporally associated with COVID-19

Islam, Meriam; Chou, Munazzah; Braithwaite, Tasanee; Siddiqui, Ata

doi:10.1016/s2665-9913(21)00272-1

Cited by 11 publications

(6 citation statements)

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“…Posterior involvement in KD is rare and is usually limited to case reports (13). Similarly, fundus findings in MIS-C are scarce in the literature, but some reports have demonstrated normal findings, as described in this case (6,7,9). Considering that both MIS-C and KD mainly involve the anterior segment of the eyes, we speculate that MIS-C and KD have a similar pathogenesis.…”

Section: Discussionmentioning

confidence: 76%

“…To date, only one report has described bilateral anterior scleritis concomitant with anterior uveitis. In this report a 17-year-old boy with MIS-C complained of bilateral red eyes, eye pain, photophobia, and blurring of vision, with subsequent fever that occurred 1-week after post-admission, and after a 3-day course of intravenous methylprednisolone and tocilizumab administration ( 6 ). His eye condition required additional oral prednisolone and eye drops (0.1% dexamethasone) for up to a 6-week period.…”

Section: Discussionmentioning

confidence: 98%

“…Therefore, MIS-C can present with various clinical features. While the literature is limited regarding ocular reports associated with MIS-C, anterior uveitis has recently been reported in addition to conjunctivitis (5)(6)(7)(8)(9). The present case was unique for the following two reasons: 1) the patient showed severe ocular manifestations as the primary symptom of MIS-C prior to other findings, such as fever or gastrointestinal manifestations, which could lead to delay in diagnosis, and 2) he suffered anterior scleritis, an unusual and severe form of inflammatory eye disease, rather than conjunctivitis.…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Anterior Scleritis Presenting as a Primary Ocular Manifestation in Multisystem Inflammatory Syndrome in Children With COVID-19

et al. 2022

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Multisystem inflammatory syndrome in children (MIS-C) is a newly defined hyperinflammatory disease linked to antecedent coronavirus disease 2019. Patients with MIS-C present with various symptoms, and ocular findings such as mild bilateral conjunctivitis are relatively common. However, detailed descriptions of severe ocular reports associated with MIS-C are scarce in the current literature. Here we report a case of MIS-C in a Japanese boy, with severe eye manifestations in the form of anterior scleritis as the primary MIS-C symptom. Detailed ocular examinations by ophthalmologists may be key for clarifying the pathophysiology of MIS-C.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Case Report: Anterior Scleritis Presenting as a Primary Ocular Manifestation in Multisystem Inflammatory Syndrome in Children With COVID-19

et al. 2022

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“…22 There are several case reports of episcleritis, anterior scleritis, and uveitis associated with COVID-19 infection, but no reported cases or series of posterior scleritis, as we document herein. [23][24][25][26] It has long been suspected that vaccinations can predispose to autoimmune conditions. 27 In ammatory ocular conditions, particularly uveitis, have previously been described following vaccination.…”

Section: Discussionmentioning

confidence: 99%

Posterior Scleritis Following COVID-19 Vaccination or Infection Simulating Uveal Melanoma in 8 Consecutive Patients

Negretti¹,

Zeiger²,

Cherkas³

et al. 2023

Preprint

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Objectives To determine clinical features and outcomes of posterior scleritis masquerading as uveal melanoma following vaccination against COVID-19 and/or COVID-19 infection. Subjects/Methods: All patients with posterior scleritis referred to our service to rule out intraocular tumor between February 2021 and June 2022, who previously had COVID-19 vaccination and/or infection (n = 8). A retrospective detailed review of patient charts and imaging was carried out. Results Previous COVID-19 vaccination was documented in 6 patients (75%) and previous COVID-19 infection and vaccination in 2 patients (25%). Demographic features included mean age of 59 years (median 68, range 5–86 years), white race (n = 7, 87%), and male sex (n = 5, 63%). Mean visual acuity at presentation was 0.24 LogMAR (median 0.18, range 0.0-0.70). The main presenting symptom was blurred vision with pain (n = 5, 63%). Features that suggested scleritis and not uveal melanoma included pain (n = 6, 75%), anterior scleritis (n = 3, 38%), disc edema (n = 1, 13%), choroidal detachment (n = 3, 38%), choroidal folds (n = 3, 38%), diffusely thickened scleral wall on ultrasonography (n = 2, 25%), Tenon’s edema (n = 5, 63%), and scleral nodule with medium/high internal reflectivity on ultrasonography (n = 4, 50%). Follow-up information at mean of 2 months (range 0.25-7 months) revealed visual acuity at date last seen was mean 0.30 LogMAR (median 0.29, range 0.0-0.54). By 2 months, resolution of “tumor” was noted in 5/6 (83%) patients with follow-up. Conclusions Posterior scleritis following COVID-19 vaccination and/or infection can masquerade as choroidal melanoma. At 2 months duration, partial or complete resolution of features with minimal visual consequence was noted.

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“… 48 , 49 Severe binocular scleritis has also been reported as the main symptom or one of the main symptoms in children suffering from multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C). 50 , 51 …”

Section: Ophthalmological Symptoms In the Course Of Covid-19mentioning

confidence: 99%

The Review of Ophthalmic Symptoms in COVID-19

Stawowski,

Konopińska,

Stawowski

et al. 2024

OPTH

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The COVID-19 pandemic caused by SARS-CoV-2 had a significant impact on the health of the global human population, affecting almost every human organ, including the organ of vision. Research focus on understanding the pathophysiology, identifying symptoms and complications of the disease. Eye-related pathologies are important foci of research due to the potential for direct impact of the virus. Ophthalmologists around the world are reporting various symptoms of eye infections and ocular pathologies associated with SARS-CoV-2. The review of ophthalmic symptoms was conducted to help physicians of various specialties recognize possible ophthalmic manifestations of this viral disease. A literature review was conducted from January 2020 to July 2023 in the PubMed, MEDLINE, Science Direct, Scopus, Scielo and Google Scholar databases. The review of the literature showed that conjunctivitis is the most common ophthalmic symptom observed during the course of COVID-19 and can occur at any stage of the disease. Changes in the eye may result from the direct effect of the virus, immune response, prothrombotic states, comorbidities, and medications used. Symptoms related to the organ of vision can be divided into: changes affecting the protective apparatus of the eye, the anterior eye segment, the posterior eye segment, neuro-ophthalmic, and orbital changes. Ocular symptoms may suggest COVID-19 infection or appear several weeks after recovery. Following COVID-19 vaccinations, a diverse range of ophthalmic symptoms was observed in various locations and at different times, mirroring the ocular symptoms experienced throughout the course of the COVID-19 illness. It is important for physicians of all specialties to be aware of possible potential connections between eye diseases and SARS-CoV-2, in order to effectively diagnose and treat patients.

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Bilateral anterior non-necrotising scleritis, anterior uveitis, and unilateral facial nerve palsy in paediatric inflammatory multisystem syndrome temporally associated with COVID-19

Cited by 11 publications

References 0 publications

Case Report: Anterior Scleritis Presenting as a Primary Ocular Manifestation in Multisystem Inflammatory Syndrome in Children With COVID-19

Case Report: Anterior Scleritis Presenting as a Primary Ocular Manifestation in Multisystem Inflammatory Syndrome in Children With COVID-19

Posterior Scleritis Following COVID-19 Vaccination or Infection Simulating Uveal Melanoma in 8 Consecutive Patients

The Review of Ophthalmic Symptoms in COVID-19

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