{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T07:41:38Z","timestamp":1770277298571,"version":"3.49.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001786","name":"The University of Adelaide","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001786","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The purpose of the study was to report three cases of orbital inflammation following administration of the COVID-19 vaccination, manifesting as Tolosa\u2013Hunt syndrome (THS) and orbital myositis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>A retrospective case series and literature review of patients who developed orbital inflammation following a COVID-19 vaccination.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One patient presented with Tolosa\u2013Hunt syndrome (THS) 14\u00a0days following her third (booster) COVID-19 vaccination, one patient developed orbital myositis 10\u00a0days following his first COVID-19 vaccination and one patient developed recurrent orbital myositis 1 and 7\u00a0days following her second and fourth COVID-19 vaccination. All patients received the Comirnaty vaccine (Pfizer-BioNTech). A thorough systemic autoimmune disease workup in both patients was unremarkable. Two patients had a prior history of orbital inflammation, with previous involvement of other different orbital structures. Characteristic MRI features for each pathology were observed, supporting the clinical presentation of THS and orbital myositis. There was complete resolution of THS following corticosteroids, with no recurrence at 2\u00a0months. Meanwhile, one case of orbital myositis self-resolved at 2\u00a0months without use of systemic corticosteroids, while the other patient with orbital myositis required treatment with intra-orbital steroid injections and oral corticosteroids.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Orbital inflammation has been recognised as a rare adverse effect following COVID-19 vaccination. We present a case series of THS and orbital myositis as varied presentations of this entity.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10792-023-02747-6","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T16:02:07Z","timestamp":1684339327000},"page":"3391-3401","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Orbital inflammation following COVID-19 vaccination: A case series and literature review"],"prefix":"10.1007","volume":"43","author":[{"given":"Terence","family":"Ang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica Y.","family":"Tong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandy","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jwu Jin","family":"Khong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinesh","family":"Selva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"issue":"6","key":"2747_CR1","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1097\/apo.0000000000000453","volume":"10","author":"TPH Lin","year":"2021","unstructured":"Lin TPH, Ko CN, Zheng K, Lai KHW, Wong RLM, Lee A et al (2021) COVID-19: update on its ocular involvements, and complications from its treatments and vaccinations. Asia Pac J Ophthalmol (Phila) 10(6):521\u2013529. https:\/\/doi.org\/10.1097\/apo.0000000000000453","journal-title":"Asia Pac J Ophthalmol (Phila)"},{"issue":"1","key":"2747_CR2","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s40123-021-00415-5","volume":"11","author":"XL Ng","year":"2022","unstructured":"Ng XL, Betzler BK, Ng S, Chee SP, Rajamani L, Singhal A et al (2022) The eye of the storm: COVID-19 vaccination and the eye. Ophthalmol Ther 11(1):81\u2013100. https:\/\/doi.org\/10.1007\/s40123-021-00415-5","journal-title":"Ophthalmol Ther"},{"issue":"6","key":"2747_CR3","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1080\/09273948.2021.1976221","volume":"29","author":"XL Ng","year":"2021","unstructured":"Ng XL, Betzler BK, Testi I, Ho SL, Tien M, Ngo WK et al (2021) Ocular adverse events after COVID-19 vaccination. Ocul Immunol Inflamm 29(6):1216\u20131224. https:\/\/doi.org\/10.1080\/09273948.2021.1976221","journal-title":"Ocul Immunol Inflamm"},{"issue":"7","key":"2747_CR4","doi-asserted-by":"publisher","first-page":"e16791","DOI":"10.7759\/cureus.16791","volume":"13","author":"TY Chuang","year":"2021","unstructured":"Chuang TY, Burda K, Teklemariam E, Athar K (2021) Tolosa-Hunt Syndrome Presenting After COVID-19 Vaccination. Cureus. 13(7):e16791. https:\/\/doi.org\/10.7759\/cureus.16791","journal-title":"Cureus."},{"key":"2747_CR5","doi-asserted-by":"publisher","first-page":"251581632210789","DOI":"10.1177\/25158163221078977","volume":"5","author":"T Etheridge","year":"2022","unstructured":"Etheridge T, Jones J, Caskey EL, Digre KB, Warner JE, Seay MD (2022) Tolosa-hunt syndrome after COVID-19 infection. Cephalalgia Reports 5:25158163221078976. https:\/\/doi.org\/10.1177\/25158163221078977","journal-title":"Cephalalgia Reports"},{"key":"2747_CR6","doi-asserted-by":"publisher","DOI":"10.1080\/01676830.2022.2042825","author":"GSP Murphy","year":"2022","unstructured":"Murphy GSP, Gounder PA, Rajak S (2022) Acute bilateral orbital myositis following Covid 19 vaccination. Orbit. https:\/\/doi.org\/10.1080\/01676830.2022.2042825","journal-title":"Orbit"},{"key":"2747_CR7","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-248441","author":"T Murphy","year":"2022","unstructured":"Murphy T, Raheem Abu Shanab A, Kang K, Lyons CJ (2022) Acute-onset dacryoadenitis following immunisation with mRNA COVID-19 vaccine. BMJ Case Rep. https:\/\/doi.org\/10.1136\/bcr-2021-248441","journal-title":"BMJ Case Rep"},{"key":"2747_CR8","doi-asserted-by":"publisher","DOI":"10.1097\/iop.0000000000002161","author":"ER Reshef","year":"2022","unstructured":"Reshef ER, Freitag SK, Lee NG (2022) Orbital inflammation following COVID-19 vaccination. Ophthalmic Plast Reconstr Surg. https:\/\/doi.org\/10.1097\/iop.0000000000002161","journal-title":"Ophthalmic Plast Reconstr Surg"},{"issue":"6","key":"2747_CR9","doi-asserted-by":"publisher","first-page":"e05926","DOI":"10.1002\/ccr3.5926","volume":"10","author":"S Grunenwald","year":"2022","unstructured":"Grunenwald S, Lethellier G, Imbert P, Dekeister C, Caron P (2022) Orbital inflammatory disease following mRNA SARS-CoV-2 vaccine. Clin Case Rep. 10(6):e05926. https:\/\/doi.org\/10.1002\/ccr3.5926","journal-title":"Clin Case Rep."},{"key":"2747_CR10","doi-asserted-by":"publisher","DOI":"10.1080\/09273948.2022.2093757","author":"A YucelGencoglu","year":"2022","unstructured":"YucelGencoglu A, Mangan MS (2022) Orbital Inflammatory Pseudotumor following mRNA COVID-19 Vaccination. Ocul Immunol Inflamm. https:\/\/doi.org\/10.1080\/09273948.2022.2093757","journal-title":"Ocul Immunol Inflamm"},{"key":"2747_CR11","doi-asserted-by":"publisher","DOI":"10.1177\/11206721221123780","author":"G Savino","year":"2022","unstructured":"Savino G, Gambini G, Scorcia G, Comi N, Fossataro C, Stanislao R (2022) Orbital myositis and scleritis after anti-SARS-CoV-2 mRNA vaccines: a report of three cases. Eur J Ophthalmol. https:\/\/doi.org\/10.1177\/11206721221123780","journal-title":"Eur J Ophthalmol."},{"key":"2747_CR12","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines10020342","author":"AA Haseeb","year":"2022","unstructured":"Haseeb AA, Solyman O, Abushanab MM, Abo Obaia AS, Elhusseiny AM (2022) Ocular complications following vaccination for COVID-19: a one-year retrospective. Vaccines (Basel). https:\/\/doi.org\/10.3390\/vaccines10020342","journal-title":"Vaccines (Basel)."},{"issue":"1","key":"2747_CR13","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s12348-021-00275-x","volume":"12","author":"I Testi","year":"2022","unstructured":"Testi I, Brand\u00e3o-de-Resende C, Agrawal R, Pavesio C (2022) Ocular inflammatory events following COVID-19 vaccination: a multinational case series. J Ophthalmic Inflamm Infect 12(1):4. https:\/\/doi.org\/10.1186\/s12348-021-00275-x","journal-title":"J Ophthalmic Inflamm Infect"},{"issue":"2","key":"2747_CR14","doi-asserted-by":"publisher","first-page":"679","DOI":"10.4103\/ijo.IJO_2374_21","volume":"70","author":"M Roy","year":"2022","unstructured":"Roy M, Chandra A, Roy S, Shrotriya C (2022) Optic neuritis following COVID-19 vaccination: coincidence or side-effect?\u2013\u2013a case series. Indian J Ophthalmol 70(2):679\u2013683. https:\/\/doi.org\/10.4103\/ijo.IJO_2374_21","journal-title":"Indian J Ophthalmol"},{"key":"2747_CR15","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-246485","author":"MP Cicalese","year":"2022","unstructured":"Cicalese MP, Ferrua F, Barzaghi F, Cerri F, Moro M, Aiuti A et al (2022) Third cranial nerve palsy in an 88-year-old man after SARS-CoV-2 mRNA vaccination: change of injection site and type of vaccine resulted in an uneventful second dose with humoral immune response. BMJ Case Rep. https:\/\/doi.org\/10.1136\/bcr-2021-246485","journal-title":"BMJ Case Rep."},{"issue":"6","key":"2747_CR16","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1080\/09273948.2021.1961815","volume":"29","author":"HM Leber","year":"2021","unstructured":"Leber HM, Sant\u2019Ana L, Konichi da Silva NR, Raio MC, Mazzeo T, Endo CM et al (2021) Acute thyroiditis and bilateral optic neuritis following SARS-CoV-2 vaccination with CoronaVac: a case report. Ocul Immunol Inflamm. 29(6):1200\u20136. https:\/\/doi.org\/10.1080\/09273948.2021.1961815","journal-title":"Ocul Immunol Inflamm."},{"key":"2747_CR17","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.12688\/f1000research.74299.2","volume":"10","author":"T Kubota","year":"2021","unstructured":"Kubota T, Hasegawa T, Ikeda K, Aoki M (2021) Case Report: Isolated, unilateral oculomotor palsy with anti-GQ1b antibody following COVID-19 vaccination. F1000Res. 10:1142. https:\/\/doi.org\/10.12688\/f1000research.74299.2","journal-title":"F1000Res."},{"issue":"5","key":"2747_CR18","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.jaapos.2021.05.003","volume":"25","author":"DP Reyes-Capo","year":"2021","unstructured":"Reyes-Capo DP, Stevens SM, Cavuoto KM (2021) Acute abducens nerve palsy following COVID-19 vaccination. J aapos 25(5):302\u2013303. https:\/\/doi.org\/10.1016\/j.jaapos.2021.05.003","journal-title":"J aapos"},{"issue":"1","key":"2747_CR19","doi-asserted-by":"publisher","first-page":"42","DOI":"10.31157\/an.vi.329","volume":"27","author":"RP Molina-Martinez","year":"2022","unstructured":"Molina-Martinez RP, Vega-Moreno DA, Ochoa-Mena JD, L\u00f3pez-Zapata MdR, Garc\u00eda-Gonz\u00e1lez U (2022) Tolosa-Hunt syndrome associated with coronavac\/Sinovac vaccination against Covid-19. Archivos de Neurociencias. 27(1):42\u20135. https:\/\/doi.org\/10.31157\/an.vi.329","journal-title":"Archivos de Neurociencias."},{"key":"2747_CR20","doi-asserted-by":"publisher","first-page":"100885","DOI":"10.1016\/j.preteyeres.2020.100885","volume":"81","author":"MJ Lee","year":"2021","unstructured":"Lee MJ, Planck SR, Choi D, Harrington CA, Wilson DJ, Dailey RA et al (2021) Non-specific orbital inflammation: current understanding and unmet needs. Prog Retin Eye Res. 81:100885. https:\/\/doi.org\/10.1016\/j.preteyeres.2020.100885","journal-title":"Prog Retin Eye Res."},{"issue":"3","key":"2747_CR21","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1136\/bjo.2009.175190","volume":"95","author":"WR Bijlsma","year":"2011","unstructured":"Bijlsma WR, van Gils CH, Paridaens D, Mourits MP, Kalmann R (2011) Risk factors for idiopathic orbital inflammation: a case\u2013control study. Br J Ophthalmol 95(3):360\u2013364. https:\/\/doi.org\/10.1136\/bjo.2009.175190","journal-title":"Br J Ophthalmol"},{"issue":"3","key":"2747_CR22","doi-asserted-by":"publisher","first-page":"e100","DOI":"10.1097\/iop.0000000000001847","volume":"37","author":"BH Chon","year":"2021","unstructured":"Chon BH, Hwang CJ, Perry JD (2021) Unilateral ptosis, proptosis, and orbital myositis after shingles vaccination. Ophthalmic Plast Reconstr Surg 37(3):e100\u2013e103. https:\/\/doi.org\/10.1097\/iop.0000000000001847","journal-title":"Ophthalmic Plast Reconstr Surg"},{"issue":"1","key":"2747_CR23","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1093\/rheumatology\/36.1.120","volume":"36","author":"G Thurairajan","year":"1997","unstructured":"Thurairajan G, Hope-Ross MW, Situnayake RD, Murray PI (1997) Polyarthropathy, orbital myositis and posterior scleritis: an unusual adverse reaction to influenza vaccine. Br J Rheumatol 36(1):120\u2013123. https:\/\/doi.org\/10.1093\/rheumatology\/36.1.120","journal-title":"Br J Rheumatol"},{"issue":"6","key":"2747_CR24","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1016\/j.jcjo.2011.09.018","volume":"46","author":"MJ Belliveau","year":"2011","unstructured":"Belliveau MJ, Kratky V, Evans GA, Almeida DR, El-Defrawy S (2011) Acute orbital inflammatory syndrome following H1N1 immunization. Can J Ophthalmol 46(6):552\u2013553. https:\/\/doi.org\/10.1016\/j.jcjo.2011.09.018","journal-title":"Can J Ophthalmol"},{"issue":"1","key":"2747_CR25","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.1097\/iop.0000000000001517","volume":"36","author":"A Basilious","year":"2020","unstructured":"Basilious A, Jivraj I, DeAngelis D (2020) Acute unilateral ptosis and myositis following the H1N1 influenza vaccine. Ophthalmic Plast Reconstr Surg 36(1):e16\u2013e17. https:\/\/doi.org\/10.1097\/iop.0000000000001517","journal-title":"Ophthalmic Plast Reconstr Surg"},{"issue":"4","key":"2747_CR26","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1080\/09273948.2021.1887282","volume":"29","author":"MS Mangan","year":"2021","unstructured":"Mangan MS, Yildiz E (2021) New onset of unilateral orbital myositis following mild COVID-19 infection. Ocul Immunol Inflamm 29(4):669\u2013670. https:\/\/doi.org\/10.1080\/09273948.2021.1887282","journal-title":"Ocul Immunol Inflamm"},{"issue":"6","key":"2747_CR27","doi-asserted-by":"publisher","first-page":"2075","DOI":"10.1016\/j.jaci.2021.04.002","volume":"147","author":"KA Risma","year":"2021","unstructured":"Risma KA, Edwards KM, Hummell DS, Little FF, Norton AE, Stallings A et al (2021) Potential mechanisms of anaphylaxis to COVID-19 mRNA vaccines. J Allergy Clin Immunol 147(6):2075\u201382.e2. https:\/\/doi.org\/10.1016\/j.jaci.2021.04.002","journal-title":"J Allergy Clin Immunol"},{"issue":"4","key":"2747_CR28","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1016\/j.jaip.2020.12.047","volume":"9","author":"A Banerji","year":"2021","unstructured":"Banerji A, Wickner PG, Saff R, Stone CA Jr, Robinson LB, Long AA et al (2021) mRNA vaccines to prevent COVID-19 disease and reported allergic reactions: current evidence and suggested approach. J Allergy Clin Immunol Pract 9(4):1423\u20131437. https:\/\/doi.org\/10.1016\/j.jaip.2020.12.047","journal-title":"J Allergy Clin Immunol Pract"}],"container-title":["International Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10792-023-02747-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10792-023-02747-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10792-023-02747-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T04:06:48Z","timestamp":1691035608000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10792-023-02747-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,17]]},"references-count":28,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["2747"],"URL":"https:\/\/doi.org\/10.1007\/s10792-023-02747-6","relation":{},"ISSN":["1573-2630"],"issn-type":[{"value":"1573-2630","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,17]]},"assertion":[{"value":"6 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The authors do not have any conflicts of interests or funding sources to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interests"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Written informed consent was obtained from the patients for publication of this report and accompanying images.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}