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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1378341



Case Details

VAERS ID: 1378341 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Angiogram normal, Blindness unilateral, Computerised tomogram head normal, Computerised tomogram neck, Eye pain, Magnetic resonance imaging head normal, Optic nerve cupping, Retinal artery occlusion, Retinal oedema, Retinal pallor, Scan with contrast normal, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Glaucoma (narrow), Optic nerve disorders (narrow), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT Head and Neck with contrast and MRI/MRA were normal. Ophthalmology Physician diagnosed as arterial occlusion of ophthalmic artery despite patent arteries on imaging
CDC Split Type:

Write-up: Patient developed painful blurry vision in left eye that progressed to painless blurry vision in same eye within 24 hours after onset of symptoms. Patient had edematous and pale retina with swollen optic cup. Patient has had complete vision loss in his left eye since.


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