COVID-19 Associated Bilateral Acute Iris Transillumination

Area of Science:

• Ophthalmology
• Infectious Diseases

Background:

• Coronavirus disease 2019 (COVID-19) is a global pandemic.
• Ocular manifestations of COVID-19 are increasingly reported.
• Bilateral acute iris transillumination (BAIT) is a rare ocular condition.

Observation:

• A 44-year-old female patient presented with acute visual decline, ocular pain, photophobia, and redness in both eyes.
• The patient had a history of close contact with a severe acute respiratory syndrome - coronavirus-2 (SARS-CoV-2) case and was hospitalized for bilateral pneumonia.
• Ophthalmic examination revealed decreased visual acuity, corneal endothelial pigment deposition, anterior chamber pigment dispersion, iris depigmentation, and iris transillumination defects.

Findings:

• The patient exhibited signs consistent with bilateral acute iris transillumination (BAIT).
• Elevated intraocular pressure (IOP) was noted in both eyes (32 mmHg right, 38 mmHg left).
• The patient received topical anti-inflammatory and anti-glaucomatous treatment.

Implications:

• This case highlights that rare ocular conditions, such as BAIT, can be associated with COVID-19.
• Clinicians should consider COVID-19 as a potential cause for BAIT in patients with relevant exposure history.
• Early recognition and management of ocular manifestations in COVID-19 patients are crucial.