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This is VAERS ID 1771668

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First Appeared on 10/15/2021

VAERS ID: 1771668
VAERS Form:2
Age:69.0
Sex:Female
Location:South Carolina
Vaccinated:2021-03-13
Onset:2021-10-01
Submitted:0000-00-00
Entered:2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 2 LA / IM

Administered by: Military      Purchased by: ??
Symptoms: Eye pain, Vision blurred, Visual impairment, Vitreous detachment, Vitreous floaters, Vitritis, Ophthalmological examination abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Livalo, Losartan, Yuvafem, Vit D and E, Fish Oil, CoQ10, Aspirin, Percocet, Rozerem, Dayvigo,
Current Illness: None
Preexisting Conditions: HTN, CHD/CVD
Allergies: Demerol (?)
Diagnostic Lab Data: Many Oct 7, 2021 no results yet
CDC 'Split Type':

Write-up: August 12, 2021 sudden large increase in visual floaters. Oct 1, 2021 exceptional increase in visual floaters followed by decreased clouded vision left eye. Oct 2, 2021 sudden onset eyeball pain left eye with listed visual decline and floaters. Oct 2, 2021 Diagnosis Posterior Vitreous Detachment with increased vitreous debris/Vitritis left eye. Referral to specialist Oct 6, 2021 Eye specialist verified unusual viritis left eye and referred to retinal specialist. Oct 7, 2021 Retinal specialist confirmed vitritis but also asked many autoimmune questions and ordered many such tests as this condition is unusual in a person of my age.

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