Visual Consequences Research Articles

Inability to pursue nonrigid motion produces instability of spatial perception.

Vision generates a stable representation of space by combining retinal input with internal predictions about the visual consequences of eye movements. We report a type of nonrigid motion that disrupts the connection between eye movements and perception, causing visual instability. This motion is accurately perceived during fixation, but it cannot be pursued. Catch-up saccades are accurately directed to the moving target but the motion stimulus appears to jump in space with each saccade. Our results reveal four major findings about perception and the visuomotor system: (i) Pursuit fails for certain types of motion; (ii) pursuit and catch-up saccades are independently controlled; (iii) prediction of saccade consequences is independent from saccade control; and (iv) the visual stability of moving objects relies on similar motion mechanisms as pursuit.

Neural correlates of sensorimotor adaptation: thalamic contributions to learning from sensory prediction error

Understanding the neural mechanism of sensorimotor adaptation is essential to reveal how the brain learns from errors, a process driven by sensory prediction errors. While the previous literature has focused on cortical and cerebellar changes, the involvement of the thalamus has received less attention. This functional magnetic resonance imaging study aims to explore the neural substrates of learning from sensory prediction errors with an additional focus on the thalamus. Thirty participants adapted their goal-directed reaches to visual feedback rotations introduced in a step-wise manner, while reporting their predicted visual consequences of their movements intermittently. We found that adaptation initially engaged the cerebellum and fronto-parietal cortical regions, which persisted as adaptation progressed. By the end of adaptation, additional regions within the fronto-parietal cortex and medial pulvinar of the thalamus were recruited. Another finding was the involvement of bilateral medial dorsal nuclei, which showed a positive correlation with the level of motor adaptation. Notably, the gradual shift in the predicted hand movement consequences was associated with activity in the cerebellum, motor cortex and thalamus (ventral lateral, medial dorsal, and medial pulvinar). Our study presents clear evidence for an involvement of the thalamus, both classical ‘motor’ and higher-order nuclei, in error-based motor learning.

Epidemiology and characteristics of unintentional self-inflicted penetrating ocular injuries in children less than 6 years-old

IntroductionPediatric ocular injuries, notably unintentional self-inflicted penetrating ocular injuries in children under 6, pose a substantial public health concern, leading to visual impairment and psychological distress. With global prevalence indicating severe visual impairment or blindness in 2–14% of affected children, these injuries necessitate multiple surgeries and extended monitoring. Our study aims to analyze the epidemiology and characteristics of such injuries, emphasizing preventive measures, parental supervision, and timely medical intervention to mitigate their impact on young lives.MethodConducted at Khalili Hospital in Shiraz, Iran, our retrospective study included 141 cases admitted between April 2018 and April 2023. Ethical principles guided data collection from medical records, encompassing demographic details, causative objects, ocular laceration specifics, surgical procedures, complications, and visual acuity assessments.ResultsThe mean age of the participants in this study was 47.18 ± 16.48 months (ranging from 10 to 71 months), and the male to female ratio was 1.76:1 (90 vs. 51). Objects of injury mostly included knives (34.8%), wood (12.1%), and glass (10.6%), and the most common initial manifestation of injury was iris prolapse (56.7%), followed by traumatic cataract (46.8%) and limbus laceration (34.0%). Fifteen (10.6%) patients had a visual acuity better than LogMAR 0.5, 24 (17.1%) had finger count vision, 37 (26.2%) had hand motion, 7 (0.5%) had light perception, and 58 (41.1%) were uncooperative. Type of laceration and season of injury were associated with retinal detachment, and a longer time-to-visit was correlated with a higher risk of developing retinal detachment or endophthalmitis.ConclusionOur study highlights the significant burden of unintentional self-inflicted penetrating ocular injuries in children under 6. Emphasizing preventive measures, parental supervision, and timely medical intervention, our findings underscore the potential psychological and visual consequences. This research advocates for parental education and safety measures to reduce the occurrence and severity of such injuries in this vulnerable population, promoting a healthier and safer environment for children.

Are Optometrists Prepared to Be Involved in Post-Stroke Rehabilitation?

Stroke survivors often experience various visual consequences that impact their daily life and may benefit from visual interventions. However, some of these usually go unaddressed as optometrists are rarely included in the post-stroke care pathway. Yet, optometrists are interested in contributing to the care of these patients. This survey evaluated the readiness of optometrists in diagnosing and managing visual disorders specific to stroke survivors. A questionnaire was developed by the researchers, pilot tested by 5 research optometrists and 15 community optometrists, and modified based on the feedback. Practicing optometrists were invited to complete the anonymous online survey through optometric organizations in Canada, the US, Hong Kong, India, and the UK. Most respondents displayed strong knowledge, but 61.6% indicated that enhancing their knowledge would be helpful. The majority (87%) agreed that stroke is related to an increased incidence of falls. Participants' knowledge regarding the natural history of post-stroke visual disorders was poorer. There were also inconsistencies regarding what optometrists considered ideal interventions and what they undertook in practice. More than 50% of respondents reported that the quality of published evidence on post-stroke visual consequences was low or nonexistent. Overall, survey respondents displayed sufficient knowledge. However, there are areas of uncertainty in their knowledge, which in many cases correspond to real gaps in the available evidence. There is a need to identify and remediate these gaps to enable optometrists to deliver quality optometric care as collaborative members of the post-stroke professional team, which would eventually improve the rehabilitation of stroke survivors.

A life-threatening running nose with visual consequences

A life-threatening running nose with visual consequences

Spatially resolved imaging of human macular capillaries using adaptive optics-enhanced optical coherence tomography angiography

Documenting the organization of the retinal capillaries is of importance to understand the visual consequences of vascular diseases which may differentially affect the microvascular layers. Here we detailed the spatial organization of the macular capillaries in ten healthy human subjects using a prototypic adaptive optics-enhanced optical coherence tomography angiography (AO-OCTA) system. Within the central 6° × 6°, the radial peripapillary capillaries and the superficial, intermediate and deep vascular plexuses (SVP, IVP and DVP, respectively) were consistently resolved. In 8 out of the 10 eyes, the capillary segments composing the perifoveal arcade (PFA) were perfused only by the SVP, while drainage of the PFA showed more variability, comprising a case in which the PFA was drained by the DVP. Around the center, a distinct central avascular zone could be documented for each layer in 7 of the 10 cases; in three eyes, the IVP and SVP merged tangentially around the center. In all eyes, the foveal avascular zone was larger in the DVP than in the SVP and IVP. In one eye with incomplete separation of the inner foveal layers, there was continuity of both the SVP and the IVP; a central avascular zone was only present in the DVP. The diversity of perfusion and drainage patterns supported a connectivity scheme combining parallel and serial organizations, the latter being the most commonly observed in perifoveal vessels. Our results thus help to further characterize the diversity of organization patterns of the macular capillaries and to robustly analyze the IVP, which will help to characterize early stages of microvascular diseases.

Awareness of Diabetic Retinopathy among Patients with Diabetes Mellitus Attending the Tertiary Eye Hospital in Nepal: A Descriptive Cross-sectional Study

Abstract Introduction: Lack of knowledge of the need for regular diabetic retinopathy screening (DRS) has turned many patients in the advanced stage of DR before first eye check-ups. Unfortunately, data on the knowledge, attitude, and behaviour of diabetic patients with DR are not satisfactory in Nepal. Here, we aim to assess the factors predisposing to awareness levels in the Nepalese context. Methods: This was an observational cross-sectional study enrolling 369 diabetic patients visiting the Hospital for Children, Eye, ENT and Rehabilitation Services between March 2020 and February 2021 after obtaining ethical clearance from the Nepal Health Research Council. A convenience sampling technique was used. The questionnaire was utilized to assess basic demographic profiles, awareness about diabetic retinopathy, and sources of information on the need for diabetic eye check-ups. Results: The mean (standard deviation) age of diabetes mellitus (DM) patients was 56.26 (11.13) years. The age group of 40–59 years comprised more than half of the total patients. Awareness of DR was 86.7% in this study. Education level and the duration of DM were directly proportional to the awareness level. Healthcare workers or physicians were the primary sources of information on awareness. Conclusions: Awareness of poor visual consequences of DR among patients with diabetes in Nepal is relatively satisfactory. However, patients’ willingness to undergo retinopathy check-ups was not up to the mark. Therefore, we recommend finding out the barrier to poor compliance with diabetic retinopathy in the future. The consumer-focussed health educational interventions and physician-based skills and the DRS facility would improve the awareness level in Nepal.

Prediction of sensorimotor contingencies generates saccadic omission

With every movement of our eyes, the visual receptors in the retina are swiped across the visual scene. Saccades are the fastest and most frequent movements we perform, yet we remain unaware of the self-produced visual motion. Previous research has tried to identify a dedicated suppression mechanism that either actively or passively cancels vision at the time of saccades.1 Here, we investigated a novel theory, which states that saccadic omission results from habituation to the predicted sensory consequences of our own actions. We experimentally induced novel, i.e., artificial visual consequences of saccade performance by presenting gratings that were drifting faster than the flicker fusion frequency and that became visible only when participants performed saccades. We asked participants to perform more than 100 saccades in each session across these gratings to make the novel contingencies predictable for the sensorimotor system. We found that contrast sensitivity for intra-saccadic motion declined drastically after repeated exposure of such motion. The reduction in sensitivity was even specific to the saccade vector performed in habituation trials. Moreover, when subjects performed the same task in fixation, no reduction in sensitivity was observed. In a motion speed comparison task, we found that the reduction in contrast sensitivity is the consequence of silencing-predicted intra-saccadic visual motion. Our data demonstrate that the sensorimotor system selectively habituates to recurring intra-saccadic visual motion, suggesting an efficient prediction mechanism of visual stability.

Acute vision threatening thyroid orbitopathy associated with cataract surgery: A case series and review of the literature

Thyroid eye disease can be associated via cataract surgery with devastating visual consequences. A systematic review of the clinical records of patients with aggravation of their thyroid orbitopathy after eye surgery at a tertiary facility was performed. Patients who had worsening of their thyroid orbitopathy within the post-operative period of cataract surgery were included. Clinical findings were reviewed including clinical examination and imaging. A literature review was also performed. Two patients who underwent cataract surgery and presented with newly diagnosed and severe thyroid orbitopathy post-operatively were identified. Both patients were male, averaging 71 years of age. Both patients noticed symptoms of diplopia within one week after cataract surgery and had clinical and imaging findings consistent with severe thyroid orbitopathy. Both patients required urgent bilateral orbital decompression due to compressive optic neuropathy. Visual acuity was preserved in both patients. The average follow-up was 6 years. Males who have activation of TED after cataract surgery appear to have a higher risk of developing compressive optic neuropathy and require immediate intervention, which is consistent with male gender as a risk factor for severe disease. Patients with thyroid disease should be counselled pre-operatively about the risk of disease aggravation after cataract surgery.

Parental Awareness of the Preschool Orthoptics Visual Screening in Brunei-Muara District and Factors Contributing to Defaulters.

The preschool orthoptics visual screening program began in Brunei Darussalam in 2004 to detect amblyopia, a common cause of treatable visual disorders in children. Amblyopia can be asymptomatic, easily missed, and cause permanent adverse visual consequences; hence, it is necessary to be screened. The parental role in ensuring timely visual screening is pivotal to their child's visual well-being and educational success. This study explored parental awareness and reasons for their nonattendance. A cross-sectional study of 401 parents was conducted in the Brunei-Muara district in private kindergarten schools and maternal and child health clinics. A self-designed and self-administered questionnaire was used. Data collected was analysed using RStudio in the form of descriptive and analytic statistics. The study findings showed that 52.8% defaulted their screening and there was a significant association between parental awareness and the defaulters (p < 0.05). Only 39.9% of parents were aware of the screening service availability, and 50.1% had not taken their children for an eye check. The most significant sociodemographic factor that influenced awareness of the importance of vision screening was parental employment status (p = 0.013), revealing a 4.43 times higher likelihood of default if the father was unemployed. This study found that with each additional child, parents are 1.25 times less likely to seek eye screening (p < 0.05). The main reason for nonattendance was a lack of awareness of the situation and parents believed that their children were seeing well. Mitigating child visual screening defaults requires a community-focused approach.

Blast injury: Impact to the cornea

Visual disorders are common even after mild traumatic brain injury (mTBI) or blast exposure. The cost of blast-induced vision loss in civilians, military personnel, and veterans is significant. The visual consequences of blasts associated with TBI are elusive. Active military personnel and veterans report various ocular pathologies including corneal disorders post-combat blasts. The wars and conflicts in Afghanistan, Iraq, Syria, and Ukraine have significantly increased the number of corneal and other ocular disorders among military personnel and veterans. Binocular vision, visual fields, and other visual functions could be impaired following blast-mediated TBI. Blast-associated injuries can cause visual disturbances, binocular system problems, and visual loss. About 25% of veterans exposed to blasts report corneal injury. Blast exposure induces corneal edema, corneal opacity, increased corneal thickness, damage of corneal epithelium, corneal abrasions, and stromal and endothelial abnormality including altered endothelial density, immune cell infiltration, corneal neovascularization, Descemet membrane rupture, and increased pain mediators in animal models and the blast-exposed military personnel including veterans. Immune response exacerbates blast-induced ocular injury. TBI is associated with dry eyes and pain in veterans. Subjects exposed to blasts that cause TBI should undergo immediate clinical visual and ocular examinations. Delayed visual care may lead to progressive vision loss, lengthening/impairing rehabilitation and ultimately may lead to permanent vision problems and blindness. Open-field blast exposure could induce corneal injuries and immune responses in the cornea. Further studies are warranted to understand corneal pathology after blast exposure. A review of current advancements in blast-induced corneal injury will help elucidate novel targets for potential therapeutic options. This review discusses the impact of blast exposure-associated corneal disorders.

Endophthalmitis after cataract surgery and effect of different intracameral antibiotic regimes in Sweden 2011-2017: national registry study.

To study the incidence, predictive factors, etiology, and visual consequences of postoperative endophthalmitis (PE) in relation to 3 intracameral (IC) antibiotic regimes. Swedish National Cataract Register entries from 2011 through 2017. Observational retrospective study. PE incidence, influencing factors, bacteriology, and visual outcome were analyzed regarding the 3 major prophylactic IC protocols. The overall incidence of PE was 0.023% or 177 cases in 764 513 cataract procedures. Analyzed per IC regime, the rates of PE were 0.024% (126 cases in 514 916 surgeries) for cefuroxime, 0.020% (25 cases in 122 340 surgeries) for moxifloxacin, and 0.017% (20 cases in 121 045 surgeries) for combined cefuroxime-ampicillin. Incidences were not statistically significantly different from one another. Gram-positive bacteria caused 89.0% of culture positive cases. Enterococci as pathogens were significantly more frequent with IC cefuroxime than with moxifloxacin, P = .006, or cefuroxime-ampicillin, P < .001, while streptococci other than enterococci were more common with moxifloxacin than with cefuroxime, P < .001. Bacterial susceptibility to the given antibiotics was demonstrated in 21.3% of PE cases treated with cefuroxime, which was statistically significantly lower than proportions found with cefuroxime-ampicillin, 60.0%, P = .015, or with moxifloxacin, 88.2%, P < .001. Visual outcome worse than 20/200 was similar in the groups ranging from 42.0% to 53.7%. No statistically significant differences in PE incidence or visual outcome results between treatment groups were demonstrated. However, differences in etiology and bacterial sensitivity were found between the prophylactic IC treatments.

Management of a Large and Strange Intraocular Foreign Body: Case Report

Introduction: Intraocular foreign bodies (IOFBs) are unusual and can cause serious eye damage. Case Presentation: We present a case report of a 62-year-old male patient who presented to our ophthalmic emergency department with an intraocular foreign body following a domestic accident.Imaging evaluation with facial CT scan confirmed the presence of a foreign body, made of glass, without any associated bone fractures. Conclusion: Previous studies have emphasized the potential complications and visual consequences associated with these injuries.This case report contributes to the existing literature on intraocular foreign bodies and reinforces the importance of prompt diagnosis and appropriate management.

Visual acuity and visual field as a function of disease duration in patients with birdshot chorioretinitis

BackgroundBirdshot chorioretinitis (BSCR) is a chronic bilateral posterior uveitis, which can affect central as well as peripheral vision. The aim of this study was to assess how visual acuity and...

Paediatric CXL myths and reality

Paediatric keratoconus is often an undiagnosed condition that results in many cases being untreated. As this patient population has a vulnerable developing visual system, a delay in treatment can lead to lifelong visual consequences. Published studies demonstrate that keratoconus progresses at a faster rate in children compared to adults and that CXL can arrest disease progression also in paediatric patients. Current barrier to the CXL treatment may be partly due to the lack of compliance during a procedure performed using local anaesthesia. In addition, children may not comply with instructions to avoid eye rubbing that increases the risk of regression over time and the chance for postoperative infection.

In Vitro Cytocompatibility Analysis and Comparison of Different Hyaluronic Acid Fillers for Minimally Invasive Esthetics.

To overcome the natural visual consequences of the physiological aging process, the use of biodegradable fillers made of hyaluronic acid or sodium carboxymethyl cellulose is increasingly popular in modern esthetic medicine. Clinicians can choose from a wide range of fillers with variable compositions and rheological properties, and therefore with different application areas and injection depths. The aim of this study was to analyze and compare the most commonly used fillers for facial augmentation regarding their in vitro biocompatibility and to find potential correlations to their rheological properties. In the present study, direct and indirect in vitro cytotoxicity analysis according to DIN EN ISO 10993-5 were performed on 39 different filler materials for facial augmentation. All fillers analyzed in this study overall showed satisfactory results in the direct and indirect cytocompatibility tests. While no material was outside the threshold values in the 2,3-bis-(2-methoxy-4-nitro-5-sulphenyl)-(2H)-tetrazolium-5-carboxanilide (XTT) cell viability and bromodeoxyuridine (BrdU) cell proliferation assays or in the live-dead staining, only 7 out of the 39 fillers reached the required values in the lactate dehydrogenase assay. All biodegradable fillers examined in this study were found to be sufficiently cytocompatible. Although the qualitative analysis of the test results showed differences between the fillers, no concrete correlation between test performance and composition or manufacturer of the fillers was found. Future efforts are required to provide clinicians with even better support in choosing the right filler for optimal outcome and patient satisfaction.

Model matters: Differential outcomes in traumatic optic neuropathy pathophysiology between blunt and blast-wave mediated head injuries

Over 3 million people in the United States live with long-term disability because of a traumatic brain injury (TBI). The purpose of this study was to characterize and compare two different animal models of TBI (blunt head trauma and blast TBI) to determine common and divergent characteristics of these models. With recent literature reviews noting the prevalence of visual system injury in animal models of TBI, coupled with clinical estimates of 50–75% of all TBI cases, we decided to assess commonalities, if they existed, through visual system injury. A unilateral (left directed) blast and repeat blast model injury with coup-contra-coup injury patterns were compared to a midline blunt injury. Injuries were induced in adult male mice to observe and quantify visual deficits. Retinal ganglion cell loss and axonal degeneration in the optic tract, superior colliculus, and lateral geniculate nuclei were examined to trace injury outcomes throughout major vision-associated areas. Optokinetic response, immunohistochemistry, and western blots were analyzed. Where a single blunt injury produces significant visual deficits a single blast injury appears to have less severe visual consequences. Visual deficits after repeat blasts are similar to a single blast. Single blast injury induces contralateral damage to the right optic chiasm and tract whereas bilateral injury follows a single blunt TBI. Repeat blast injuries are required to see degeneration patterns in downstream regions similar to the damage seen in a single blunt injury. This finding is further supported by amyloid precursor protein (APP) staining in injured cohorts. Blunt injured groups present with staining 1.2 mm ahead of the optic nerve, indicating axonal breakage closer to the optic chiasm. In blast groups, APP was identifiable in a bilateral pattern only in the geniculate nucleus. Evidence for unilateral neuronal degeneration in brain tissue with bilateral axonal ruptures are pivotal discoveries in this model differentiation. Analysis of the two injury models suggests that there is a significant difference in the histological outcomes dependent on injury type, though visual system injury is likely present in more cases than are currently diagnosed clinically.

Poster Session: Oculomotor influences on retinal input signals in myopia.

Studies of emmetropization have traditionally focused on the spatial characteristics of visual input signals. Yet the input to the retina is not a two-dimensional pattern but a temporally-varying luminance flow. The temporal structure of this flow is predominately determined by eye movements, as the human eyes move incessantly. Even when fixating on a single point, a persistent motion known as ocular drift reformats the luminance flow in a way that counterbalances the spectra of natural scenes. It is established that emmetropes are highly sensitive to these luminance modulations. However, their visual consequences in myopia and hyperopia are unknown. Here, we first review how the temporal-frequency distribution of retinal input signals varies with the amount of ocular drift. We then use a detailed optical/geometrical model of the eye to study how the eye movements jointly shape retinal input as a function of refraction. We show that, within the temporal range of sensitivity of the retina, the spatial frequency distribution of the input signals conveys signed information about defocus. Specifically, for a given degree of defocus, myopic retinas experience more power from low spatial frequency stimuli than hyperopic retinas. These redistribution of input power may have a consequence during eye growth supporting the proposal that eye movements should be taken into consideration in the process of emmetropization.

Prevalence and Visual Consequences of Non-adherent Patients Receiving Anti-vascular Endothelial Growth Factor (VEGF) Injections at King Fahad Specialist Hospital (KFSH), Qassim Region.

Anti-vascular endothelial growth factor (VEGF) injection treatment is a widely utilized therapy for various retinal diseases, including diabetic macular edema (DME). Therefore, the importance of compliance and follow-up should be discussed with the patient. There have been no studies conducted in the Qassim region to estimate the prevalence of patients missing their anti-VEGF appointments. To fulfill this need, we conducted this study to evaluate the compliance rate of patients treated with anti-VEGF injections for DME as well as to determine the visual consequences of the delay in anti-VEGF treatment in the Qassim region. This observational retrospective cohort study was conducted at King Fahad Specialist Hospital (KFSH) in the Qassim region of Saudi Arabia. We extracted all file numbers of patients who were using intravitreal anti-VEGF injections to treat DME. The data were managed and analyzed using the IBM Statistical Package for the Social Sciences (SPSS) software (IBM Corp., Armonk, NY, USA). In the current study, we were able to collect data from 198 patients who received anti-VEGF treatment in the hospital. Among the participants, 57.6% were male, with a mean age of 61.7 years old (standard deviation (SD) = 10.23). Among the patients, we found that the rate of non-adherence to the anti-VEGF injection was 54.5%, and those patients delayed their scheduled doses for more than 56 days. In 47.5% of the patients, delaying or stopping their appointments had no known reason; however, blepharitis was the main reason for delaying or stopping the dose in 27.7% of the patients, followed by endophthalmitis in 18.7% of the patients. There is no significant difference between before and after stopping the treatment, considering visual acuity (VA) or optical coherence tomography (OCT). However, regarding the disease progression, we found that 15 out of the 30 patients had worsened in the OCT after they missed their injections (mean increase in the VA was 6.069 (SD = 97.45), t = -0.278, P = 0.783, and decrease in the OCT was -14.9667 (SD = 133.87, P = 0.454). There is a high rate of patients who missed their appointments for an anti-VEGF injection. This resulted in the worsening of OCT in half of the 30 patients who were enrolled in the visual consequences study, which had a negative impact on treatment and disease progression.

Posterior scleritis following COVID-19 vaccination or infection simulating uveal melanoma in 8 consecutive patients.

To determine clinical features and outcomes of posterior scleritis masquerading as uveal melanoma following vaccination against COVID-19 and/or COVID-19 infection. All patients with posterior scleritis referred to our service to rule out intraocular tumour between February 2021 and June 2022, who previously had COVID-19 vaccination and/or infection (n = 8). A retrospective detailed review of patient charts and imaging was carried out. Previous COVID-19 vaccination was documented in 6 patients (75%) and previous COVID-19 infection and vaccination in 2 patients (25%). Demographic features included mean age of 59 years (median 68, range 5-86 years), white race (n = 7, 87%), and male sex (n = 5, 63%). Mean visual acuity at presentation was 0.24 LogMAR (median 0.18, range 0.0-0.70). The main presenting symptom was blurred vision with pain (n = 5, 63%). Features that suggested scleritis and not uveal melanoma included pain (n = 6, 75%), anterior scleritis (n = 3, 38%), disc oedema (n = 1, 13%), choroidal detachment (n = 3, 38%), choroidal folds (n = 3, 38%), diffusely thickened scleral wall on ultrasonography (n = 2, 25%), Tenon's oedema (n = 5, 63%), and scleral nodule with medium/high internal reflectivity on ultrasonography (n = 4, 50%). Follow-up information at mean of 2 months (range 0.25-7 months) revealed visual acuity at date last seen was mean 0.30 LogMAR (median 0.29, range 0.0-0.54). By 2 months, resolution of "tumour" was noted in 5/6 (83%) patients with follow-up. Posterior scleritis following COVID-19 vaccination and/or infection can masquerade as choroidal melanoma. At 2 months duration, partial or complete resolution of features with minimal visual consequence was noted.