Tonic pupil after COVID-19 infection

Quijano-Nieto, Bernardo; Córdoba-Ortega, C.M.

doi:10.1016/j.oftale.2021.01.001

Cited by 5 publications

(7 citation statements)

References 6 publications

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“…Few cases have also documented Adie's tonic pupil in COVID-10 patients; one, coexisting with multifocal chorioretinitis, explained earlier ( 54 ), which along with other cases of Adie's tonic pupil, reported in the literature ( 79 – 81 ), suggest rare patterns of neurological involvement by SARS-CoV-2. Papillophlebitis is another uncommon ocular involvement in COVID-19 patients, presenting with painless, unilateral, slight diminution of vision, characterized by venous congestion and optic disc edema, tortuous retinal vessels, retinal hemorrhages, and confirmed by OCT and FA results.…”

Section: Resultsmentioning

confidence: 85%

Update on overview of ocular manifestations of COVID-19

Akbari

Dourandeesh²

2022

Front. Med.

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The coronavirus disease 2019 (COVID-19) has become the most critical health crisis at present, and research is continued about the exact pathophysiology, presentations, and complications of this pandemic. It influences several organs, and many studies have addressed the organs, the involvement of which during the COVID-19 results in patients' death. One of the important organs that can be involved during COVID-19, which is also a transmission route of the disease, is the eye. According to the evidence, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can have ocular manifestations and complications. According to the literature, conjunctivitis is the most common presentation, which can develop at any stage of COVID-19 (during and even after the disease), and the major pathophysiology of the eye involvement during the disease is attributed to the direct effect of the virus on the eyes, tissue damage caused by inflammation, underlying diseases, and the adverse effect of the medications prescribed. There are also reports of life-threatening complications, such as rhino-orbital cerebral mucormycosis, which require urgent treatment and are associated with a great mortality rate. Ocular manifestations may also be the presentation of a life-threatening event, such as stroke; therefore, it is necessary to pay great attention to the ocular manifestations during COVID-19. In this review, after about 2 years of the pandemic started, we present a narrative review on ocular manifestations during COVID-19, categorized into three main categories; ophthalmic, orbital, and neuro-ophthalmological manifestations with a detailed description of the presenting symptoms, risk factor, diagnostic, and therapeutic strategies suggested for each.

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Section: Resultsmentioning

confidence: 85%

Update on overview of ocular manifestations of COVID-19

Akbari

Dourandeesh²

2022

Front. Med.

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“…In the context of COVID-19, cases of tonic pupil (Adie's pupil), both unilateral 101 and bilateral 102 , have been observed. It is a symptom resulting from weakened parasympathetic innervation of the pupillary sphincter muscle, which leads to a weak reaction of the pupil to light, while relatively good accommodation is maintained.…”

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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“…[29,30] SARS-CoV-2 is associated with pathologies of the afferent visual pathways including optic neuritis (idiopathic [5,14,[31][32][33] or immunemediated), [3,4,[17][18][19][20][21][22] optic nerve infarction, [34] papillophlebitis, [35] and idiopathic intracranial hypertension. [36][37][38] The efferent visual pathways can be lesioned by COVID-19-related isolated cranial neuropathies, [9,27,[39][40][41] nystagmus, [42][43][44][45][46] tonic pupil, [47][48][49][50][51] Horner's syndrome, [12,13,52] and opsoclonus-myoclonus-ataxia syndrome (OMAS). [53][54][55] Mucormycosis infections, [56] which are of exponentially increasing incidence in COVID-19 patients, can occur as a superinfection and result in lesions of the afferent or efferent visual pathways or even both.…”

Section: Mechanisms Of Neurologic Involvement In Covid-19mentioning

confidence: 99%

“…Tonic (Adie's) pupil refers to parasympathetic denervation of the pupil sphincter, which causes poor constriction of the pupil to the light but the reaction to the accommodation remains relatively spared. Tonic pupil has been reported in association with COVID-19, including unilateral [47] and bilateral [48] cases. One patient with COVID-19related bilateral tonic pupil also had inflammatory multifocal choroiditis.…”

Section: Pupillary Abnormalitiesmentioning

confidence: 99%

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Neuro-ophthalmic Manifestations of Coronavirus Disease 2019 and Its Vaccination: A Narrative Review

Feizi

Isen

Tavakoli

2023

JOVR

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Coronavirus disease 2019 (COVID-19) is a current pandemic caused by SARS-CoV-2 that has vastly affected the whole world. Although respiratory disease is the most common manifestation of COVID-19, the virus can affect multiple organs. Neurotropic aspects of the virus are increasingly unfolding, in so far as some respiratory failures are attributed to brainstem involvement. The neuro-ophthalmic manifestations of COVID-19 and the neuro-ophthalmic side effects of vaccination were reviewed. The major findings are that the SARS-CoV-2 infection commonly causes headaches and ocular pain. It can affect the afferent and efferent visual pathways by ischemic or inflammatory mechanisms. Optic nerve may be the origin of transient or permanent visual loss from papillophlebitis, idiopathic intracranial hypertension, or optic neuritis. Cerebrovascular strokes are not uncommon and may lead to cortical visual impairment or optic nerve infarction. SARSCoV- 2 may affect the pupillomotor pathways, resulting in tonic pupil (Adie’s syndrome) or Horner’s syndrome. Cranial neuropathies including third, fourth, sixth, and seventh nerve palsies have all been reported. Rhino-orbital mucormycosis superinfections in COVID-19 patients receiving steroids or other immunosuppressive therapies may result in unilateral or bilateral visual loss and ophthalmoplegia. Autoimmune conditions such as Guillain- Barré, Miller-Fisher syndrome, and ocular myasthenia have been reported.

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Tonic pupil after COVID-19 infection

Cited by 5 publications

References 6 publications

Update on overview of ocular manifestations of COVID-19

Update on overview of ocular manifestations of COVID-19

The Review of Ophthalmic Symptoms in COVID-19

Neuro-ophthalmic Manifestations of Coronavirus Disease 2019 and Its Vaccination: A Narrative Review

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