Supplementary Material for: Transient Myopia and Ciliochoroidal Effusion following Influenza Vaccination

Introduction: The aim of the study was to report a case of ocular adverse events following influenza vaccination which involved bilateral myopic shift, ciliochoroidal effusion, and fine retinal folds in a middle-aged woman. Case Presentation: A 42-year-old female presented with sudden-onset painless binocular decreased distance vision. She had received a quadrivalent influenza vaccine (Influvac Tetra) injection 10 days prior, a few days after which she experienced blurred vision. Her initial uncorrected visual acuity and refraction were 20/200 and −3.00/−1.00 × 180 in the right eye, 20/100 and −3.00/−0.50 × 50 in the left eye. Intraocular pressure was within normal limits bilaterally. Anterior segment examination was significant for bilateral shallow anterior chambers (AC) and narrow iridocorneal angles with no cells or flare. Fundus examination was notable for bilateral fine chorioretinal folds radiating from the macula and bilateral low-lying choroidal effusion in the far periphery. Ultrasound biomicroscopy confirmed bilateral ciliochoroidal effusions, shallow AC, and anterior rotation of the ciliary bodies. The patient was started on oral and topical corticosteroids plus atropine and timolol eye drops after which prompt improvement was observed. Restoration of visual acuity and complete resolution of the symptoms without any further complication were observed after 2 weeks. Conclusion: The temporal association between the onset of the patient’s symptoms and influenza vaccination, in the absence of any pertinent medical conditions or medications, significantly implicates causality. Future research and case reports can help in corroborating this ocular adverse event attributed to influenza vaccination.