Introduction
In December 2019, the world faced the outbreak of coronavirus disease 2019, known as COVID-19, of which the Severe Acute Respiratory Syndrome Coronavirus-2 was known as the causative pathogen. When the virus started to spread all over the world, in the beginning of March 2020, WHO officially declared the disease as a pandemic (2). Inevitably, mass vaccination became the only way to prevent and control the unleashed pandemic (3). Within about two years, 155 vaccine candidates were developed, of which 23 were authorized, following different strategies: inactivated, mRNA, viral vector, nanoparticle-based peptide vaccines, etc. All authorized vaccines have shown promising efficacy, but the Adverse Events (AEs) and Serious AEs (SAEs) remained an unknown challenge (4). The most common AEs were injection site pain or tenderness, fatigue, headache, rash, fever, chill, as well as myalgia, and arthralgia (5). Moreover, thrombosis and thrombocytopenia, myocarditis or pericarditis, inflammatory myositis, and autoimmune diseases were frequently reported SAEs (5). The exact mechanism remains vague, however, immune cross-reactivity by antibodies produced after vaccination, bystander activation of T cells which is also responsible for rheumatic autoimmune diseases, adjuvants, and even additive substances to preserve the vaccine could all induce autoreactivity (6). To date few studies have reported cases of ocular inflammatory AEs after the first or second dose of vaccination, including white dot syndrome, pan uveitis, choroiditis, along with scleritis and episcleritis (7). More importantly, not only approach to SAEs is important but also, they can masquerade as connective tissue diseases highlighting that late intervention could result in eye lost.
Herein, we reported a case of 52-year-old woman presented with simple anterior scleritis following third dose of Sinopharm COVID-19 vaccination.