Posterior scleritis following COVID-19 vaccination or infection simulating uveal melanoma in 8 consecutive patients.

Publication date: Jul 08, 2023

To determine clinical features and outcomes of posterior scleritis masquerading as uveal melanoma following vaccination against COVID-19 and/or COVID-19 infection. All patients with posterior scleritis referred to our service to rule out intraocular tumour 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. 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 oedema (n = 1, 13%), choroidal detachment (n = 3, 38%), choroidal folds (n = 3, 38%), diffusely thickened scleral wall on ultrasonography (n = 2, 25%), Tenon’s oedema (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 “tumour” was noted in 5/6 (83%) patients with follow-up. 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.

Concepts Keywords
February Choroidal
June Covid
Scleritis Infection
Vaccination Median


Type Source Name
disease MESH scleritis
disease MESH COVID-19
disease VO vaccination
disease MESH infection
disease MESH uveal melanoma
disease IDO symptom
disease MESH choroidal detachment
disease MESH melanoma
pathway KEGG Melanoma

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