VAERS ID: |
946141 (history) |
Form: |
Version 2.0 |
Age: |
83.0 |
Sex: |
Female |
Location: |
Indiana |
Vaccinated: | 2021-01-14 |
Onset: | 2021-01-14 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-14 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
- / UNK |
- / - |
Administered by: Public Purchased by: ? Symptoms: Blindness unilateral,
Computerised tomogram,
Neurological examination,
Ophthalmological examination,
Thrombosis,
Ultrasound eye,
Visual acuity reduced SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: None Preexisting Conditions: Allergies: None Diagnostic Lab Data: Cat Scans Ultrasound of the left eye, Ophthamologist evaluation. Neurologist examination CDC Split Type:
Write-up: Moderna COVID-19 Vaccine At 2 PM I went blind in my left eye. Went to emergency room at Hospital Was told I have Blood clot in my eye causing the blindness and Ophthamologist says it will probably be permanent |