Multiple vaccines are now being used across the world, and several studies have described cases of corneal graft rejection following the administration of the COVID-19 vaccine. The purpose of this article is to review the corneal adverse event that occurred following COVID-19 vaccine administration. The literature search was conducted in March 2022 using MEDLINE, PubMed, and the Cochrane Database of Systematic Reviews. A total of 27 articles, including 37 cases, have documented corneal adverse events that occurred following COVID-19 vaccination. The mean age was 60 ± 14.9 years (range, 27–83 years). The most common events were acute corneal graft rejection (n = 21, 56.8%), followed by herpes zoster ophthalmicus (n = 11, 29.7%) and herpes simplex keratitis (n = 2, 5.4%). The mean time from vaccination to the event was 10 ± 8.5 days (range, 1–42 days) after the first or second dose of vaccine. All patients with corneal graft rejection, immune-mediated keratolysis, and peripheral ulcerative keratitis (PUK) (n = 24, 64.9%) were managed topically with or without oral corticosteroids. Patients with herpes zoster ophthalmicus and herpes simplex keratitis were managed with oral antiviral agents. Two patients received penetrating keratoplasty due to keratolysis after invalid topical treatment. Disease resolution was noted in 29 patients (78.3%), whereas 3 (8.1%) had persistent corneal edema after graft rejection, 1 (2.7%) had corneal infiltration after HZO, and 4 (10.8%) were not mentioned in the articles. Corneal adverse events could occur after COVID-19 vaccination. After timely treatment with steroids or antiviral agents, most of the events were mild and had a good visual outcome. Administrating or increasing steroids before vaccination may be useful for the prevention of corneal graft rejection. However, the prophylactic use of antiviral treatments in patients with a herpes viral infection history is not recommend.

Purpose: The aim was to analyze the association of subfoveal choroidal thickness (SFCT) with age, best-corrected visual acuity, refractive error, and axial length in Taiwan pediatric population. Methods: A total of 374 eyes in 187 children were enrolled in this retrospective cross-sectional comparative study, who underwent examinations of best-corrected visual acuity (BCVA), cycloplegic refraction, and axial length (AL). Subfoveal choroidal thickness was assessed utilizing spectral domain enhanced depth imaging optical coherence tomography (EDI-OCT), with measurements taken at the subfovea, defined as the distance from the retinal pigment epithelium to the chorioscleral border. Results: The mean age was 5.6 ± 1.9 years (range 2–16 years). The cycloplegic spherical equivalent refractive error was between + 7.25 and - 15.25 diopters (D) and cycloplegic sphere power was between + 8.25 and - 11.5 diopters (D). The mean SFCT was 299.0 ± 69.80 μm. The mean axial length was 22.87 ± 1.29 mm. In univariate analysis, SFCT had significant positive correlations with spherical equivalent (SE) and sphere power (p < 0.05) and significant negative correlations with age, cylinder power, and axial length (p < 0.05). However, after adjusting in the multivariate regression analysis, spherical equivalent, sphere power and age were not independently associated with SFCT. In multivariate analysis, lower cylinder power and longer axial length have significant correlations with thinner SFCT. The relationship between best-corrected visual acuity and SFCT was not significant in both analyses. Conclusions: This study showed that mean subfoveal choroidal thickness was 299.0 ± 69.80 μm among Taiwanese children. The SFCT was thinner in myopic, longer axial length, and lower cylinder power eyes.