Bilateral central retinal artery occlusion with optic neuropathy, cerebral stroke, and mucormycosis in post-COVID patient – A rare presentation

Nowadays, COVID-19 is a worldwide pandemic disease. The clinical features of this disease are not fully understood, especially the interaction of COVID-19 and preexisting comorbidities and how these together further impair the immune system. COVID-19 has been associated with inflammatory-induced homeostasis changes leading to severe coagulopathy with multi-organ involvement. The burden of thromboembolic complications in COVID-19 patients is currently unknown. The pathogenesis of retinal artery occlusions is a multifactorial process where inflammation and hypercoagulation state are established risk factors. The severity of the disease is currently managed with systemic glucocorticoids, and hence the chances of opportunistic fungal infections are more. It is likely that COVID-19 patients could be at risk of developing retinal vascular occlusions. Focused ophthalmological surveillance is advisable to prevent and manage this possible cause of severe vision loss. Here, we report a unique case of bilateral central retinal artery occlusion (CRAO) with optic neuropathy, cerebral stroke, and mucormycosis of the para-nasal sinus in a 52 years old male diabetic patient with a previous history of severe COVID-19 disease.