Uncommon presentation of COVID-19 in ophthalmology: a case report

Cisca Kuswidyati; Klarissa Chrishalim; Andre

doi:10.15562/bmj.v11i1.3006

Uncommon presentation of COVID-19 in ophthalmology: a case report

Cisca Kuswidyati ,

Klarissa Chrishalim ,

Andre ,

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DOI: https://doi.org/10.15562/bmj.v11i1.3006 |
Published: 2022-04-08

Abstract

Introduction: The COVID-19 pandemic is well known for its clinical respiratory symptoms. Currently, the medical literature describing the neuro-ophthalmologic manifestations of COVID-19 is gradually emerging. We hereby report a case with an uncommon presentation of COVID-19 in a patient.

Case Report: A 19-year-old man presented with ptosis and limited left eye movement in his left eye followed by other neurological manifestations, without classical respiratory manifestations. Brain imaging and nasopharyngeal PCR suggest COVID-19 encephalitis.

Conclusion: This experience confirms that COVID-19 infections can be present despite the absence of significant respiratory symptoms mimicry to other symptoms. Therefore, physicians should consider the possibility of COVID-19 infections, and time management may lead to a better outcome.

References

WHO Coronavirus (COVID-19) Dashboard [Internet]. [cited 2021 Sep 13]. Available from: https://covid19.who.int
Iltaf S, Fatima M, Salman S, Salam J-U, Abbas S. Frequency of Neurological Presentations of Coronavirus Disease in Patients Presenting to a Tertiary Care Hospital During the 2019 Coronavirus Disease Pandemic. Cureus. 2020 Aug 18;12(8):e9846.
Hu K, Patel J, Swiston C, Patel BC. Ophthalmic Manifestations Of Coronavirus (COVID-19). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 Sep 3]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK556093/
Nasiri N, Sharifi H, Bazrafshan A, Noori A, Karamouzian M, Sharifi A. Ocular Manifestations of COVID-19: A Systematic Review and Meta-analysis. J Ophthalmic Vis Res. 2021 Jan 20;16(1):103–12.
Betsch D, Freund PR. Neuro-Ophthalmologic Manifestations of Novel Coronavirus. Adv Ophthalmol Optom. 2021 Aug;6:275–88.
Faucher A, Rey P-A, Aguadisch E, Degos B. Isolated post SARS-CoV-2 diplopia. J Neurol. 2020 Jun 12;1–2.
Douedi S, Naser H, Mazahir U, Hamad AI, Sedarous M. Third Cranial Nerve Palsy Due to COVID-19 Infection. Cureus. 13(4):e14280.
Belghmaidi S, Nassih H, Boutgayout S, Fakiri KE, Qadiri RE, Hajji I, et al. Third Cranial Nerve Palsy Presenting with Unilateral Diplopia and Strabismus in a 24-Year-Old Woman with COVID-19. Am J Case Rep. 2020 Oct 15;21:e925897-1-e925897-5.
Tisdale AK, Chwalisz BK. Neuro-ophthalmic manifestations of coronavirus disease 19. Current Opinion in Ophthalmology. 2020 Nov;31(6):489–94.
Ptosis: Evaluation and management Pauly M, Sruthi R - Kerala J Ophthalmol [Internet]. [cited 2021 May 21]. Available from: https://www.kjophthal.com/article.asp?issn=0976-6677;year=2019;volume=31;issue=1;spage=11;epage=16;aulast=Pauly
Goel K, Kumar A, Diwan S, Kohli S, Sachdeva HC, Ganapathy U, et al. Neurological Manifestations of COVID-19: A Series of Seven Cases. Indian J Crit Care Med. 2021 Feb;25(2):219–23.
Katti V, Ramamurthy LB, Kanakpur S, Shet SD, Dhoot M. Neuro-ophthalmic presentation of COVID-19 disease: A case report. Indian Journal of Ophthalmology. 2021 Apr;69(4):992–4.
Doblan A, Kaplama ME, Ak S, Basmacı N, Tarini EZ, Göktaş ŞE, et al. Cranial nerve involvement in COVID-19. Am J Otolaryngol. 2021;42(5):102999.
Finsterer J, Scorza FA, Scorza CA, Fiorini AC. COVID-19 associated cranial nerve neuropathy: A systematic review. Bosn J Basic Med Sci. 2022 Feb;22(1):39–45.
Fitzpatrick JC, Comstock JM, Longmuir RA, Donahue SP, Fitzpatrick JM, Bond JB. Cranial Nerve III Palsy in the Setting of COVID-19 Infection. J Neuroophthalmol. 2021 Sep 1;41(3):e286–7.

[1] WHO Coronavirus (COVID-19) Dashboard [Internet]. [cited 2021 Sep 13]. Available from: https://covid19.who.int

[2] Iltaf S, Fatima M, Salman S, Salam J-U, Abbas S. Frequency of Neurological Presentations of Coronavirus Disease in Patients Presenting to a Tertiary Care Hospital During the 2019 Coronavirus Disease Pandemic. Cureus. 2020 Aug 18;12(8):e9846.

[3] Hu K, Patel J, Swiston C, Patel BC. Ophthalmic Manifestations Of Coronavirus (COVID-19). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 Sep 3]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK556093/

[4] Nasiri N, Sharifi H, Bazrafshan A, Noori A, Karamouzian M, Sharifi A. Ocular Manifestations of COVID-19: A Systematic Review and Meta-analysis. J Ophthalmic Vis Res. 2021 Jan 20;16(1):103–12.

[5] Betsch D, Freund PR. Neuro-Ophthalmologic Manifestations of Novel Coronavirus. Adv Ophthalmol Optom. 2021 Aug;6:275–88.

[6] Faucher A, Rey P-A, Aguadisch E, Degos B. Isolated post SARS-CoV-2 diplopia. J Neurol. 2020 Jun 12;1–2.

[7] Douedi S, Naser H, Mazahir U, Hamad AI, Sedarous M. Third Cranial Nerve Palsy Due to COVID-19 Infection. Cureus. 13(4):e14280.

[8] Belghmaidi S, Nassih H, Boutgayout S, Fakiri KE, Qadiri RE, Hajji I, et al. Third Cranial Nerve Palsy Presenting with Unilateral Diplopia and Strabismus in a 24-Year-Old Woman with COVID-19. Am J Case Rep. 2020 Oct 15;21:e925897-1-e925897-5.

[9] Tisdale AK, Chwalisz BK. Neuro-ophthalmic manifestations of coronavirus disease 19. Current Opinion in Ophthalmology. 2020 Nov;31(6):489–94.

[10] Ptosis: Evaluation and management Pauly M, Sruthi R - Kerala J Ophthalmol [Internet]. [cited 2021 May 21]. Available from: https://www.kjophthal.com/article.asp?issn=0976-6677;year=2019;volume=31;issue=1;spage=11;epage=16;aulast=Pauly

[11] Goel K, Kumar A, Diwan S, Kohli S, Sachdeva HC, Ganapathy U, et al. Neurological Manifestations of COVID-19: A Series of Seven Cases. Indian J Crit Care Med. 2021 Feb;25(2):219–23.

[12] Katti V, Ramamurthy LB, Kanakpur S, Shet SD, Dhoot M. Neuro-ophthalmic presentation of COVID-19 disease: A case report. Indian Journal of Ophthalmology. 2021 Apr;69(4):992–4.

[13] Doblan A, Kaplama ME, Ak S, Basmacı N, Tarini EZ, Göktaş ŞE, et al. Cranial nerve involvement in COVID-19. Am J Otolaryngol. 2021;42(5):102999.

[14] Finsterer J, Scorza FA, Scorza CA, Fiorini AC. COVID-19 associated cranial nerve neuropathy: A systematic review. Bosn J Basic Med Sci. 2022 Feb;22(1):39–45.

[15] Fitzpatrick JC, Comstock JM, Longmuir RA, Donahue SP, Fitzpatrick JM, Bond JB. Cranial Nerve III Palsy in the Setting of COVID-19 Infection. J Neuroophthalmol. 2021 Sep 1;41(3):e286–7.

Uncommon presentation of COVID-19 in ophthalmology: a case report

Abstract

References

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