The COVID-19 vaccine: Will it affect your vision?

Fear of side effects, vision problems included, is the biggest reason why some people are hesitant to get a COVID-19 vaccine. Currently, there's no evidence that any of the available COVID-19 vaccines cause widespread vision-related side effects. Three vaccines are currently being used in the United States:

• Pfizer-BioNTech, now fully approved by the FDA under the brand name Comirnaty.
• Moderna.
• Johnson & Johnson / Janssen.

According to the CDC, the vast majority of vaccine side effects are mild, and are "normal signs that your body is building protection." They do not include eye- or vision-related symptoms.

These common side effects include:

• Pain, redness and/or swelling in the arm where you got the injection.
• Fatigue, headache, muscle pain, chills, fever and/or nausea.

These common reactions usually go away within a few days.

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Very rarely, a blood-clotting condition called TTS can occur in the weeks following a Johnson & Johnson vaccination. TTS is extremely unlikely and occurs in about 3 in every 1 million adults.

Blurry vision can be a sign of TTS, along with several other symptoms.

The rare nerve condition Guillain-Barre syndrome has also been seen in about 8 in every 1 million adults vaccinated with the J&J vaccine.

Guillain-Barre syndrome can cause eye-related symptoms such as double vision and problems moving the eyes, in addition to other neurological symptoms.

If you notice any of the symptoms of TTS or Guillain-Barre in the days or weeks after a J&J vaccine, get medical help right away.

Despite these uncommon reactions, the CDC has stressed that — compared to a COVID-19 infection — the benefits of the J&J vaccine far outweigh any risks.

While the COVID-19 vaccines have, so far, not caused notable side effects related to vision, vaccines for several other conditions have been linked to eye and vision problems.

Seasonal flu vaccine

In rare cases, some patients who’ve received the flu vaccine experienced mild symptoms like eye redness, eye pain and blurred vision.

Common side effects of the flu vaccine include:

• Soreness, redness or swelling at the injection spot
• Headache
• Fever
• Nausea
• Muscle aches  

Measles-mumps-rubella (MMR) vaccine

Some research has shown that optic neuritis is a rare complication from the vaccine for the measles-rubella (MR) vaccine. Optic neuritis is inflammation affecting the optic nerve that sends signals from the back of the eye to the brain. 

Common side effects of the MMR vaccine include:

• Fever
• Mild rash
• Swollen cheek or neck gland
• Temporary joint pain (mostly in teenage and adult females)

Rare side effects include short-term seizures and low platelet count. In extremely rare cases, the MMR vaccine can cause deafness, long-term seizures, coma or brain damage. 

Chickenpox and shingles vaccines

One study found rare instances of corneal inflammation in children (chickenpox) and adults (shingles) after they received the zoster virus vaccine for both conditions. 

Common side effects from the chickenpox vaccine include:

• Soreness and a mild rash at the injection spot
• Temporary joint pain and stiffness
• Fever

For the shingles vaccine, common side effects are:

• Soreness, redness and swelling at the injection site
• Tiredness
• Muscle pain
• Headache
• Shivering
• Fever
• Stomach pain and nausea

Around the world, measles causes as many as 60,000 cases of blindness each year, according to the American Academy of Ophthalmology (AAO). Other potential vision issues associated with measles include:

• Red and watery eyes triggered by pink eye (conjunctivitis)
• Keratitis and scarring of the cornea
• Retinopathy
• Optic neuritis
• Childhood blindness

The measles vaccine is the best option for preventing the disease and, therefore, preventing measles-related vision problems. 

SEE RELATED: 5 ways measles can affect eyesight

The AAO recommends that people 50 and over get the shingles vaccine to prevent an “extremely painful and disfiguring complication” called herpes zoster ophthalmicus, which can cause blindness.

If the shingles virus infects the nerves of the eye, the AAO says it can lead to:

• Eyelid rash
• Eye infection
• Conjunctivitis (pink eye)
• Corneal infection and inflammation
• Blurry vision
• Sensitivity to bright light
• Pain and swelling inside the eye
• Swelling of the optic nerve behind the eye
• Corneal breakdown requiring a cornea transplant

SEE RELATED: Shingles in the eye (ocular shingles)

Those and other side effects aren’t stopping eye care professionals in the U.S. from rolling up their sleeves to receive COVID-19 shots or to even administer the vaccinations.

In a Dec. 2, 2020, letter to the head of the U.S. Department of Health and Human Services, Dr. William Reynolds, president of the American Optometric Association, wrote that the organization’s members “stand ready to assist the public and aid the nation’s health care community in the response to the COVID-19 outbreak.”

Ophthalmologists in the U.S. also are engaged in the fight against COVID-19.

Dr. William Culbertson, professor of ophthalmology at the Bascom Palmer Eye Institute in Miami, told Ophthalmology Times that ophthalmologists and staff at the institute started receiving vaccinations Dec. 15, 2020.

“Although we are not frontline health care providers, we all see patients face to face at the slit lamp and in surgery, so we have all been at substantial risk until we get vaccinated,” Culbertson said. 

In addition, at least one ophthalmologist — Dr. Jorge Arroyo of Boston’s Beth Israel Deaconess Medical Center — participated in the trial of the Moderna vaccine for COVID-19.

It was a 34-year-old Chinese ophthalmologist, Li Wenliang, who was among the first to warn the world about the coronavirus outbreak in late December 2019. Dr. Li died of complications from the disease only a few weeks later.

While COVID-19 vaccines haven’t been tied to serious vision issues, researchers have detected eye problems in a number of children with the disease itself.

One study showed nearly one-fourth of children treated for COVID-19 at a Chinese hospital in early 2020 had mild eye problems. Those problems included:

• Eye discharge
• Conjunctivitis (pink eye)
• Eye rubbing
• Eye pain
• Eyelid swelling

But the study was limited. Researchers reviewed the conditions of only 216 pediatric patients.

There is no evidence to date of eye problems in children from COVID vaccines.

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