Background and Clinical Significance: To report a case of bilateral sterile intraocular inflammation following intravitreal aflibercept 8 mg (Eylea HD) injections. Case Presentation: An 89-year-old woman with bilateral neovascular age-related macular degeneration (nAMD) developed blurred vision and mild ocular pain in both eyes four days after receiving aflibercept 8 mg injections in both of her eyes. Examination revealed a marked anterior chamber reaction with Descemet’s folds, 2+ vitreous cells, and 3+ vitreous haze bilaterally. Intraocular pressures were normal, and B-scan ultrasonography confirmed attached retinas with bilateral vitreous opacities. The clinical presentation initially raised concern for infectious endophthalmitis; however, the bilateral presentation, quiet conjunctivae, and prior history of sterile inflammation after aflibercept 2 mg supported a diagnosis of sterile intraocular inflammation. The patient was hospitalized and treated with intensive topical corticosteroids, antibiotics, and cycloplegics, resulting in rapid improvement and complete resolution of symptoms within four days with recovery of baseline vision. Conclusions: Intravitreal aflibercept 8 mg can be associated with bilateral sterile intraocular inflammation, even in patients who previously tolerated standard-dose aflibercept. Awareness of this potential adverse event is essential to avoid unnecessary interventions and to guide appropriate management.

Introduction: Eye injuries caused by a high-pressure water jet are rarely reported and mostly occur in sporadic trauma. This study aimed to describe various ocular injuries caused by water jets, with a particular emphasis on injuries inflicted by water cannon vehicles used during riots. Case Presentations: This case series presents eleven eyes of 9 patients injured from a direct high-pressure water jet used by the police in Israel as a riot control measure during a demonstration. All patients admitted to the emergency room with blunt ocular trauma had undergone clinical examination by an ophthalmologist. Of which, hyphema was the most common ocular injury observed, affecting 8 out of the 11 eyes examined, followed by traumatic mydriasis and vitreous hemorrhage in 54% and 36% of patients, respectively. In this series, 2 of 9 patients required ocular surgery. Injuries requiring surgical intervention were retinal detachment, lens dislocation, and vitreous hemorrhage. Conclusion: Water jet injuries may inflict severe damage to the globe and orbital structures. Care should be taken in preventing such injuries inflicted by water cannon vehicles used during riots.