Dilemmas of Recurrent Ocular Inflammatory Disease on Immunosuppression and Corona Virus Disease Vaccination

The current study explores the occurrence of ophthalmic manifestations following coronavirus disease-19 (COVID-19) vaccination. The study discusses the case of a 72-year-old Indian male, who received oral methotrexate for ocular inflammation (recurrent post-operative uveitis with pseudoexfoliative glaucoma) and two doses of COVISHIELD™ vaccine and a booster in 2022. While he discontinued methotrexate for 2 weeks after the first dose, he continued the medication during the second and booster doses. Subsequently, he experienced mild ocular inflammation two weeks after the first dose, one day after the second dose, and one week after the booster dose. Topical steroids effectively controlled the inflammation, and an increased oral methotrexate dosage was used after the second dose. The study highlights the potential for autoimmune inflammatory syndrome following vaccination, although a definite causal link cannot be established. Nonetheless, the presence of side effects should not discourage individuals from receiving vaccinations.