To demonstrate
viral proteins/inflammatory
cytokines in a patient with unilateral keratouveitis. Retrospective case report. A 70-year-old Asian-Indian male presented with acute onset of blurring of vision in the left eye (OS) of 2 days duration. He had was
coronavirus disease 2019 (COVID-19)-positive 3 months earlier. He had undergone
cataract surgery/
retinal laser photocoagulation in both the eyes. The corrected distance visual acuity (CDVA) (Snellen) in the right eye (RE) (OD) and left eye (LE) (OS) was 20/20 and 20/80, respectively. OS showed decreased corneal sensation, Descemet's folds, mild stromal
edema, and fine and pigmented keratic precipitates with anterior chamber 1+ flare and 1+ cells. Fundus evaluation showed scattered
laser marks in the OD and temporal sectoral
laser marks in OS. He was diagnosed with viral keratouveitis in OS. Tear samples were collected on Schirmer's strips and tear wash for mass spectrometry and
cytokines, which had 368 and 451
viral proteins in the RE and LE, respectively, using nano liquid chromatography-mass spectrometry, which were more than controls. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and varicella zoster virus
proteins were detected.
Cytokine analysis using flow cytometer analysis showed higher
inflammation in OS as compared to OD. The patient was treated with oral
acyclovir and topical
steroids and resulted in resolution of his keratouveitis. SARS-CoV-2
proteins were present in the tear sample 3 months after
COVID-19. The presence of
viral proteins does not indicate causality.