Age: 37.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Optic ischaemic neuropathy, Optic nerve cupping, Papilloedema, Visual field defect
Clinical narrative: NON ARTERITIC ANTERIOR ISCHEMIC OPTIC NEUROPATHY RIGHT EYE/OPTICAL STROKE; FATIGUE; This spontaneous report received from a patient concerned a 37 year old male. The patient's weight was 190 pounds, and height was 67 inches. The patient's past medical history included appendectomy, and Covid-19. The patient stated he had a positive Covid-19 swab in December 2020. The patient's concurrent conditions included seasonal allergy, sleep apnea (compliant with use of CPAP machine), alcohol user (moderate, occasional beer), non smoker, pre-diabetic and optic discs small genetic, and the patient had no drug abuse or illicit drug usage. He stated that this made him higher risk due to the additional antibodies and that he thinks the vaccine contributed to developing this condition. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, expiry: UNKNOWN) dose was not reported, 1 total administered on 12-APR-2021 to left arm for prophylactic vaccination. Concomitant medications included diphtheria vaccine toxoid/pertussis vaccine acellular/tetanus vaccine toxoid for prophylactic vaccination, and loratadine for seasonal allergy (occasionally). On 13-APR-2021, one day after vaccination the patient experienced headache, described as the worst headache ever, excruciating, head pounding and felt like his head was splitting open. The patient stated headache was constant, lasted 8 to10 hours and was an 8/10 pain level. He took 4 ibuprofens and had no relief. He had left over Narco (fentanyl citrate) from an appendectomy and took 1 of those, which reduced the pain to a 5/10 pain level. The headache then dissipated and was gone by 19:00 to 21:00 on 13-APR-2021 and never returned after that.  On same day patient experienced fatigue and was a moderate level and lasted through the evening until 18:00 to 20:00. On April 14-APR-2021 and 15-APR-2021 he was lightly fatigued but could still function. On 03-MAY-2021, the patient had a floater in his right eye that wouldn't go away and it seemed like something on the lens of his eye. This sensation persisted for days. A couple days later, the patient did a self exam and covered his left eye, he was noticed that the bottom left corner of the right eye was grayed out and he couldn't see his nose. The floater sensation lasted all of May, along with occasional pressure behind the eye. On 25-May-2021, the patient visited his primary care provider and she recommended that he see an optometrist. The patient stated that received the TDAP (diphtheria vaccine toxoid/pertussis vaccine acellular/tetanus) vaccine at this appointment with his primary care physician. On JUN-2021, Laboratory data included: Blood pressure (NR: not provided) normal. On 03-JUN-2021, The patient visited the optometrist and it was noted that he had swelling around the optic nerve/disk and hemorrhages at the back of the right eye. It was sated that several random exams and scans were done, probably 3 or 4 at this appointment. The patient noted that his blood pressure was checked and was normal for him. On 04-JUN-2021, patient had blood work (blood test) which was normal as per patient, but HbA1C elevated at 5.8 (unspecified unit), and LDL elevated, 137 (unspecified unit) (patient was not on any medications and was trying to lowering with it diet and exercise). On 10-JUN-2021, he had a follow-up exam with the optometrist during which more scans were done.  On 24-JUN-2021, A magnetic resonance imaging of the head and eye was ordered and completed. On 30-JUN-2021, he had another optometrist follow-up, where more tests and scans were done and he was notified that the magnetic resonance imaging was normal. The optometrist diagnosed him with Non Arteritic Anterior Ischemic Optic Neuropathy and referred him to a neuro-ophthalmologist. The neuro-ophthalmologist confirmed the diagnosis of Non Arteritic Anterior Ischemic Optic Neuropathy and stated that around the optic disk there was swelling which put pressure on the optic nerve causing the stroke in the nerve. The patient stated that the neuro-ophthalmologist believed that the following risk factors were contributing factors to the development of Non Arteritic Anterior Ischemic Optic Neuropathy, which is rare in people in his age. The neuro-ophthalmologist stated that there was still swelling at the back of the right eye which appeared to be better in comparison to previous reports. The patient was recommended to follow-up with his optometrist. The patient is planning to do so on September 22. The neuro-ophthalmologist confirmed that the peripheral vision loss was likely permanent and wont return. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fatigue on 16-APR-2021, and had not recovered from non arteritic anterior ischemic optic neuropathy right eye/optical stroke. This report was serious (Other Medically Important Condition, and Disability Or Permanent Damage). This case, from the same reporter is linked to 20210429018.; Sender's Comments: V0: 20210808020-covid-19 vaccine ad26.cov2.s-Non arteritic anterior ischemic optic neuropathy right eye/optical stroke. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).