Multiple Evanescent White Dot Syndrome (MEWDS) Following COVID-19 Infection: A Presumed Recurrence

Multiple evanescent white dot syndrome (MEWDS) is a transient self-limiting likely post-viral inflammatory condition involving the outer retina and inner choroid and has been reported following several vaccinations and viral infections, including COVID-19. Photopsias are a common presenting symptom but rarely persist after the acute phase of MEWDS. We present a case of an otherwise healthy 29-year-old woman who developed persistent photopsias of the right eye following COVID-19 infection. These photopsias persisted for several months and worsened after a second COVID-19 infection, which is atypical of MEWDS. Fundus autofluorescence (FAF) demonstrated several characteristic punctate hyperautofluorescent spots. Her symptoms and fundus lesions resolved after a few weeks of diagnosis without treatment. COVID-19 has several reported ocular manifestations, including MEWDS. While most cases of MEWDS following COVID-19 infection are singular instances, our case was a presumed recurrence. MEWDS is often self-limiting, but in this case, symptoms persisted for several months, suggesting the possibility of long COVID, which is a poorly understood phenomenon.