Refractive and topographic corneal changes associated with increased inflammatory mediators in tears after COVID-19

This is a rare case report of a sudden shift to myopic astigmatism and topography alterations in a patient who experienced mild coronavirus disease 2019 (COVID-19) symptoms. A complete ophthalmologic evaluation, slit-lamp examination, corneal topography, and tear sampling for biochemical analysis were performed. Elevated corneal K-values were found, indicating abnormal anterior corneal curvature, based on the asymmetric corneal steepening index (cone location and magnitude index) in a Galilei G6 study. Tear analysis demonstrated elevated levels of interleukin (IL)-1β, IL-6, IP-10, IL-8, interferon-β, and prometalloproteinase-9. Ophthalmologists should maintain a high level of suspicion when symptoms suggestive of corneal involvement arise in patients recently infected with severe acute respiratory syndrome coronavirus 2.