Initial anterior uveitis event associated with recent novel SARS-CoV-2 (COVID-19) infection in the setting of HLA-B27

PURPOSE: To describe an atypical ocular manifestation following SARS-CoV-2 infection. OBSERVATIONS: A 27-year old previously healthy male with no past ocular history presented with pain, photophobia and red eye in his left eye (OS). His only notable mention on review of systems was a positive SARS-CoV-2 infection three weeks prior. Slit lamp examination demonstrated fine inferior keratic precipitates (KPs) in the inferior cornea and 3+ anterior chamber cells OS. There was no vitritis or chorioretinal lesions. The patient was diagnosed with his first event of acute anterior uveitis. Standard ocular inflammatory panel returned positive for HLA-B27. The postulated mechanism of initial anterior uveitis attack in the setting of COVID-19 infection was dysregulation of inflammatory cells and mediators in a patient with baseline elevated risk for ocular inflammation. CONCLUSIONS AND IMPORTANCE: It is crucial to investigate patients for HLA-B27 following initial anterior uveitis event if infected by SARS-CoV-2, as patients with HLA-B27 are at baseline higher risk of ocular inflammatory dysregulation.