glaucoma and covid 19 vaccine
2022;45(6):597-602. doi:10.1016/j.jfo.2022.01.006, Malerbi FK, Schoeps VA, T F Matos K. Paracentral acute middle maculopathy in Susac syndrome after dual exposure to SARS-CoV-2 antigen. Had the patient not contacted the office, "the infection could have moved to other parts of the eye and into the eye socket," Kozarsky says. To report three cases that developed acute angle-closure glaucoma on the background of hyponatremia due to COVID 19 infection. Fear of side effects, vision problems included, is the biggest reason why some people are hesitant to get a COVID-19 vaccine. Med Arch. Combined Central Retinal Artery and Vein Occlusion with Ischemic Optic Neuropathy After COVID-19 Vaccination. This enables the detection of any rare side effects that may emerge once many millions of people are vaccinated. Case Rep Ophthalmol Med. It's highly unlikely you will experience vision symptoms due to the COVID-19 vaccine. While the COVID-19 vaccines have, so far, not caused notable side effects related to vision, vaccines for several other conditions have been linked to eye and vision problems. These symptoms can be the result of problems like retinal tears and retinal detachments; eye strokes, which occur when a blood clot blocks an artery in the retina; or eye infections all of which can lead to scarring, permanent damage or complete vision loss. Although some patients had a previous history of uveitis-related diseases that may have predisposed them to this phenomenon, many notably did not[11]. Lee C, Park KA, Ham DI, et al. 2021;11(1):21. doi:10.1186/s12348-021-00251-5, Chen X, Wang B, Li X. Acute-onset Vogt-Koyanagi-Harada like uveitis following Covid-19 inactivated virus vaccination. Pfizer-BioNTech and Moderna COVID-19 vaccines are mRNA vaccines. ISSN 1476-5454 (online) This can also be triggered by certain medications. Cornea. Her doctors had to perform surgery to treat the condition, and tests of her eye tissue showed evidence of SARS-CoV-2. Medication failed to bring down her eye pressure, so her doctors performed surgery -- taking tissue samples in the process. 1. 5-10 cc/kg mannitol was given to all patients intravenously within 30 min. This correlated with the results from graphs in Fig. J Ophthalmic Vis Res. How older drivers can improve their driving at night, The controversial use of ivermectin as a COVID-19 treatment, Dr. Li died of complications from the disease, Hydroxychloroquine, as coronavirus treatment, may be bad for your eyes, How unproven COVID treatment ivermectin can affect your vision, Coronavirus Vaccine May Exist in Eye Disease Gene Therapy. Many of the concerns stem from perceived harms of receiving the vaccination. All cases resolved with steroid and antiviral treatment. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. The COVID-19 vaccines with reported ophthalmic reactions included the mRNA vaccine (BNT162b2, Pfizer, Brooklyn, NY, USA . Methods: Data of patients with positive PCR result for COVID 19 infection and concurrent findings of acute angle-closure glaucoma were analysed retrospectively. Delayed care due to the COVID-19 pandemic threatened to leave ophthalmology patients in thedark. Panuveitis following Vaccination for COVID-19. Indian J Ophthalmol. Eye There is no evidence to date of eye problems in children from COVID vaccines. 2021;16(3):490-501. doi:10.18502/jovr.v16i3.9443, Tsukii R, Kasuya Y, Makino S. Nonarteritic Anterior Ischemic Optic Neuropathy following COVID-19 Vaccination: Consequence or Coincidence. Researchers confirm coronavirus can infect the eye. and JavaScript. Publishers note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. July 12, 2021. Steroid treatment was initiated for patients, with mixed results ranging from improved corneal graft clarity and visual acuity[32][34] to lasting corneal defects[33][34] . Optic neuritis cases typically resolved after several days of intravenous methylprednisolone therapy to near-baseline visual acuity. glaucoma, presbyopia, cataracts and ocular hypertension,0.67 FL OZ. To examine whether anti-VEGF drug injections increase risk of glaucoma, the researchers reviewed the cases of more than 800 people in British Columbia who received bevacizumab injections to treat . Eye doctors in most states saw patients for emergencies or urgent treatments during the shutdown and closed their offices to routine care. Acute-onset central serous retinopathy after immunization with COVID-19 mRNA vaccine. Those and other side effects arent stopping eye care professionals in the U.S. from rolling up their sleeves to receive COVID-19 shots or to even administer the vaccinations. However, population-based adverse event reporting systems show that vaccination-associated retinal conditions are exceedingly rare, making it difficult to ascertain the causative nature of COVID-19 vaccination on subsequent retinal pathologies[9]. "I feel guilty," Myra concedes, "and I think over and over, 'Should I have pushed myself harder to fight my fears? Maaz A. Khan1, Bryan L. C. Loh1, Gopija Nanthagopan1, Arun James Thirunavukarasu1, Aaron P. L. Fleming1, Suraya Yusuf1, Xiu Sheng Tan1, Shravan V. Gowrishankar1, Mrudula Utukuri1, Gabriella C. A. Gilks1, Marie-Julie Anna Maria Cnudde1, Sajan Rajani1, Lionel Dufour1, Reema Pujari1, Rynda Nitiahpapand1, Paolo Scollo1, Rupert Bourne1, Geoffrey Chan1, Sharon Springdal1, Daniel Kelly1, Amy Page1, Cambridge Eye Research Centre, Department of Ophthalmology, Addenbrookes Hospital, Cambridge University Hospital NHS, Cambridge, UK, Rathin Pujari,Geoffrey Chan,Ian Tapply,Maaz A. Khan,Bryan L. C. Loh,Gopija Nanthagopan,Arun James Thirunavukarasu,Aaron P. L. Fleming,Suraya Yusuf,Xiu Sheng Tan,Shravan V. Gowrishankar,Mrudula Utukuri,Gabriella C. A. Gilks,Marie-Julie Anna Maria Cnudde,Sajan Rajani,Lionel Dufour,Reema Pujari,Rynda Nitiahpapand,Paolo Scollo,Rupert Bourne,Geoffrey Chan,Sharon Springdal,Daniel Kelly,Amy Page&Rupert R. Bourne, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK, You can also search for this author in Antibiotics and corticosteroid treatment were used to resolve symptoms and visual acuity improved to near baseline levels[35][36]. Blue eyes: Is everyone with blue eyes related? Eye allergies: How to get relief from itchy, watery eyes, Computer and digital eye strain: 10 steps for relief, Digital devices: Protecting your child's eyes, Refractive errors and refraction: How the eye sees. Retin Cases Brief Rep. 2022;16(1):5-8. doi:10.1097/ICB.0000000000001195, Book BAJ, Schmidt B, Foerster AMH. Br J Ophthalmol. Impaired antibody response to inactivated COVID-19 vaccines in hospitalized patients with type 2 diabetes Xiaoying . Patients identified Q6, Q7 and Q8 to be the aspects that COVID has affected most with 28.8%, 32.1% and 40.2% yes responses, respectively (Fig. While a few medicines blunted the COVID-19 vaccine response, one of the first real-world studies of the vaccine found it safe for people with rheumatoid arthritis and other types of . Eyeglass temples: How do you know if they're the right length? Panuveitis[14], choroiditis[15], and central serous chorioretinopathy[16] impacting the choroid were also reported reactions associated with COVID-19 vaccination. Common side effects from the chickenpox vaccine include: Soreness and a mild rash at the injection spot. 2022 May-Jun 01;38(3):e67-e70. I still experience deep inner-ear pain and excruciating headaches. The AAO recommends that people 50 and over get the shingles vaccine to prevent an extremely painful and disfiguring complication called herpes zoster ophthalmicus, which can cause blindness. 1). Currently, there's no evidence that any of the available COVID-19 vaccines cause widespread vision-related side effects. Further, corneal graft rejections were also associated with COVID-19 vaccines[23][24]. They do not include eye- or vision-related symptoms. doi:10.1056/NEJMoa2034577, Voysey M, Clemens SAC, Madhi SA, et al. Health is a serious topic and therefore we present you with engaging, straightforward and expert-reviewed content that helps you make the best decision for any health-related queries. 2021;428:117607. doi:10.1016/j.jns.2021.117607, Ng XL, Betzler BK, Testi I, et al. Iridotomy to slow progression of visual field loss in angle-closure glaucoma. Internet Explorer). Patients were treated with steroids and most were able to reach their baseline BCVA[14][15][16] . Data was gathered and analyzed by the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES). Cornea. Published online December 10, 2020:NEJMoa2034577. . Another big unknown is whether any lingering virus in patients' eye tissue will cause problems. 2020;34:12035. Pain, redness and/or swelling in the arm where you got the injection. Pujari, R., Chan, G., Tapply, I. et al. Dr. Li died of complications from the disease only a few weeks later. "In ophthalmology, the decision to skip or delay treatment rarely results in a life-or-death type of scenario," says Dr. Kenneth Neufeld, an ophthalmologist and oculoplastic surgeon at the Thomas Eye Group in the Atlanta area. A study published in 2008 concluded that optic neuritis is a rare complication from the vaccine for the measles-rubella (MR) vaccine. There have been more than 1,200 reported cases of a myocarditis or pericarditis mostly in people 30 and under who received Pfizer's or Moderna's Covid-19 vaccine, according to CDC data. These common reactions usually go away within a few days. J Coll Physicians Surg Pak. ; Johnson & Johnson's Janssen (J&J/Janssen) COVID-19 vaccine is a viral vector vaccine and can be given in some situations. The patient was a 64-year-old woman who was hospitalized for COVID-19 on Jan 31. 2021;113:116-118. doi:10.1016/j.ijid.2021.09.075, Fowler N, Mendez Martinez NR, Pallares BV, Maldonado RS. 2021;40(12):1629-1632. doi:10.1097/ICO.0000000000002844, Patel SN, Yonekawa Y. 2022;29:e01536. 2000-2023 AAV Media, LLC. The immune response induced by the vaccine is considered a pathophysiological mechanism of ocular adverse reaction following the COVID-19 vaccination. Glaucoma: What You Need To Know. Data provisional, subject to change, incomplete for some jurisdictions. Acute corneal endothelial graft rejection following COVID-19 vaccination. Due to the ongoing COVID 19 times, there is a lot of stress and anxiety which also plays an important role as a risk factor for other co-morbid conditions and glaucoma which has to be managed. "We've figured out how to safely practice medicine in the era of COVID. Introduction: To report three cases that developed acute angle-closure glaucoma on the background of hyponatremia due to COVID 19 infection. Individuals without access to the internet or who are unable to schedule their appointment online can call toll free 2-1-1 or (877) 211-6277 for assistance. New York, March 03, 2023 (GLOBE NEWSWIRE) -- Reportlinker.com announces the release of the report "Glaucoma Clinical Trial Analysis by Trial Phase, Trial Status, Trial Counts, End Points, Status . Cochrane Database Syst Rev. 2022;70(5):1817-1818. doi:10.4103/ijo.IJO_66_22, Yu S, Ritterband DC, Mehta I. It also causes watering of the eyes and blurry vision in some cases. Ng XL, Betzler BK, Ng S, Chee SP, Rajamani L, Singhal A, Rousselot A, Pavesio CE, Gupta V, de Smet MD, Agrawal R. The Eye of the Storm: COVID-19 Vaccination and the Eye. Bilateral Acute Angle Closure Glaucoma After Prone Position Ventilation for COVID-19 Pneumonia. It should be noted that there are no peer-reviewed cases of adverse COVID-19 vaccination effects in glaucoma patients[9]. ACUTE MACULAR NEURORETINOPATHY AFTER SARS-COV-2 VACCINATION. doi:10.1136/bjophthalmol-2021-319338, Abousy M, Bohm K, Prescott C, Bonsack JM, Rowhani-Farid A, Eghrari AO. Common side effects of the flu vaccine include: Soreness, redness or swelling at the injection spot. Then in May, Myra's right eye started to feel "somewhat gummy," and she noticed her night vision was almost gone. Tips for Glaucoma Patients During COVID-19. Progressive lenses: No-line multifocals for a younger you, Reading glasses: What to know before buying, Glasses that suit your personality and lifestyle, The best glasses for your face shape and skin tone, Cheap glasses: How to find a bargain on eyeglasses, Buying eyeglasses online or in person: Your choice, Performance sports sunglasses: See better, play better, Polarized sunglasses: Best for reducing glare, Prescription sunglasses: Clear, comfortable vision, Designer sunglasses: Look like a celebrity, Nonprescription sunglasses: What to know before buying, Guide to buying the best sunglasses for kids, Understanding your contact lens prescription, Bladeless LASIK: Femtosecond laser eases LASIK fears, Custom LASIK: Personalized vision correction, 8 tips to speed your cataract surgery recovery. Whilst the focus has remained on deaths due to COVID-19, the indirect effects related to reductions in the provision of ophthalmic services should not be underestimated. Also, pink eye has been reported as a symptom in some COVID-19 patients, which makes implementing rigorous safety protocols an even higher priority for eye care providers. After a systematic review of published literature (), we included 17 publications reporting an additional 38 cases of GBS related to COVID-19 vaccination (India, 10 cases; United Kingdom, 11 cases; Mexico, 7 cases; United States, 3 cases; France, 1 case; Italy, 3 cases; Malta, 1 case; Turkey, 1 case; and Qatar, 1 case) (Appendix Table).Including the case in Taiwan, these 39 cases occurred in . If the shingles virus infects the nerves of the eye, the AAO says it can lead to: Swelling of the optic nerve behind the eye, Corneal breakdown requiring a cornea transplant. New, Trending, Top rated & Bestsellers . By Amy Norton, HealthDay News. Wearing eye protection in addition to a face mask is a good idea. Google Scholar. Ophthalmologists in the U.S. also are engaged in the fight against COVID-19. In addition, we found that the cohort of patients most concerned about losing vision is 25% more likely to tick yes when asked if COVID had caused more concern, indicating that the COVID crisis has explicitly exacerbated these concerns. Management of intermittent angle closure glaucoma with Nd: YAG laser iridotomy as a primary procedure. ", Tags: Coronavirus, eye problems, eye health, Utah Gov. Fear of side effects, including how it may affect vision, ranks as the primary reason that some Americans remain hesitant to be vaccinated against the virus that causes COVID-19. Cornea. Glaucoma actually refers to a group of progressive eye diseases where the optic nerve slowly dies over time, and is usually related to pressure . ; Novavax COVID-19 vaccine is a protein subunit vaccine. A vaccine to prevent coronavirus disease 2019 (COVID-19) is perhaps the best hope for ending the pandemic. This may reflect the heightened anxiety associated with COVID as well as generalized delays in clinic follow up during the COVID pandemic. Jayaram H, Strouthidis NG, Gazzard G. The COVID-19 pandemic will redefine the future delivery of glaucoma care. While COVID-19 vaccines havent been tied to serious vision issues, researchers have detected eye problems in a number of children with the disease itself. Register for an upcoming webinar, or watch past webinars. CAS Bethesda, MD 20894, Web Policies It is an inflammatory condition that affects the episcleral tissue between the conjunctiva and the sclera, or white part of the eye. They include removing furniture in the waiting room to support social distancing, installing plexiglass barriers, performing temperature checks and mandating face masks. Bilateral uveitis after inoculation with COVID-19 vaccine: A case report. The authors declare that they have no conflict of interest. But about a week later, she experienced pain and vision loss in one eye, and then in her other eye a few days afterward. Step 1: Find a location and schedule your appointment. Angle-closure glaucoma (ACG) patients underwent examinations including axial length (AL) (IOL Master, Carl Zeiss Meditec, Dublin, CA), and central corneal thickness (SP-2000P . You are using a browser version with limited support for CSS. The most common sign of glaucoma is high eye pressure that over time damages the optic nerve and leads to a loss of peripheral vision. When she finally visited her doctor after a break of more than three months, she was legally blind. The POEM questionnaire highlights that this situation has been exacerbated by COVID. The site is secure. Glaucoma Surgery and Laser . No additional fluid therapy was given to the patients other than mannitol, and it was determined that the blood sodium level remained at normal levels after diuresis. doi:10.1136/bcr-2021-245792, Khan TA, Sidhu N, Khan L, et al. Cornea. Emerging data has also shown increased patient anxiety and concern regarding their eye care. Now, scientists have more direct evidence of it. ; These vaccines are given as a shot in the muscle of the upper arm or in the . In the meantime, to ensure continued support, we are displaying the site without styles 2021;29(4):741-742. doi:10.1080/09273948.2021.1949478, Pan L, Zhang Y, Cui Y, Wu X. She now takes additional medication and may have to undergo laser surgery. "Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in U.S. history. Ocular Adverse Events After COVID-19 Vaccination. 9 June 2021. 2021;29(6):1200-1206. doi:10.1080/09273948.2021.1961815, Helmchen C, Buttler GM, Markewitz R, Hummel K, Wiendl H, Boppel T. Acute bilateral optic/chiasm neuritis with longitudinal extensive transverse myelitis in longstanding stable multiple sclerosis following vector-based vaccination against the SARS-CoV-2. Color blind tests: Do you see colors as they really are? This World Glaucoma Week, GPs and primary health professionals are invited to an eye health and education webinar. What You Should Know as a Glaucoma Patient during COVID-19. So, what is glaucoma? The current COVID-19 pandemic has drastically altered the landscape in which glaucoma care must be delivered. Published online December 30, 2020:NEJMoa2035389. The reporting of side effects within a temporal relationship with the vaccine does not prove causality. Accessed March 12, 2022. https://covid19.who.int, Baden LR, El Sahly HM, Essink B, et al. 2021;24:101200. doi:10.1016/j.ajoc.2021.101200, Lee S, Sankhala KK, Bose S, Gallemore RP. Clipboard, Search History, and several other advanced features are temporarily unavailable. Glaucoma Clinics where the Candidate should be able to work independently and formulate treatment plans for Ophthalmology patients and list for surgery. Neufeld also performed some reconstructive procedures during the pandemic for patients who had previous skin cancer surgery around the eyes. COVID-19 vaccines are safe, effective, and free. For the shingles vaccine, common side effects are sore arm, redness and swelling at the injection site, tiredness, muscle pain, headache, shivering, fever, stomach pain and nausea. Many of the concerns stem from perceived harms of receiving the vaccination. Bookshelf And it was a Chinese ophthalmologist who, in December 2019, warned the world about what came to be known as COVID-19; the disease wound up causing his death. Provided by the Springer Nature SharedIt content-sharing initiative, Irish Journal of Medical Science (1971 -) (2022), Eye (Eye) In addition, we found that the cohort of patients most concerned about losing vision is 25% more likely to tick 'yes' when asked if COVID had caused more concern, indicating that the COVID . And even with the new surge in coronavirus cases rippling through the South and West, most eye doctors do not plan to shutter their offices again, glaucoma specialist Williams says. Hyponatremia may cause an angle-closure attack in patients with shallow anterior chamber angles.Therefore, one should be aware of the possibility of angle-closure glaucoma in patients who develop hyponatremia due to COVID 19 disease. Systemic symptoms such as fatigue, muscle pain, chills, joint pain, and fever. Ophthalmol Ther. Use VaxFinder.mass.gov to search for a vaccine appointment near you. Clinical Trials 101. The Pfizer coronavirus vaccine may be linked to a form of eye inflammation called uveitis, according to a multicenter Israeli study led by Prof. Zohar Habot-Wilner from Tel Aviv's . One hundred and twenty-six consecutive patients attending a tertiary centre glaucoma clinic over a 2-week period in September 2020 were surveyed. Members of the Addenbrookes Glaucoma COVID response consortium are listed above References. BMC Ophthalmol. What's an eye test? Coordinated by the Foundation for the National Institutes of Health, ACTIV brings together partners from government, industry, academia and non-profit organizations. For children aged 6 months-4 years who completed the Moderna primary series. GlobalData's report assesses how PA-5108's drug-specific PTSR and . N Engl J Med. COVID-19 vaccines are recommended for everyone ages 6 months and older including people with HIV, regardless of their CD4 count or viral load. Now when you get sick, the same thing happens and actually a lot of the symptoms from illnesses that we get like influenza and COVID, are actually caused not by . Unbound in its middle to allow the pupil to change size, this structure is connected to the ciliary bodythe part of the eye that produces the eye's fluid (aqueous humor) and regulates contraction and constriction . Ocular adverse events following COVID-19 vaccines, although exceedingly rare, have also been documented[8][9]. Glaucoma is the leading global cause of preventable and irreversible blindness. There are four approved or authorized vaccines in the United States. Pre-pandemic, many glaucoma units were already managing a backlog of outpatients, associated with heightened anxiety around aspects of glaucoma care [4]. RETINA. 3. https://doi.org/10.1038/s41433-021-01425-0, DOI: https://doi.org/10.1038/s41433-021-01425-0. COVID-19 is a viral disease that primarily affects the respiratory system. One study showed nearly one-fourth of children at a Chinese hospital who were treated in January, February and March 2020 for COVID-19 had developed mild eye problems. doi:10.1002/ccr3.5471. Indian J Ophthalmol. In the US, the Centers for Disease Control and Prevention said people with a history of vaccine allergies can get the Covid-19 vaccine. Lancet. 2019;19:192. Ophthalmic Plast Reconstr Surg. This page was last edited on November 10, 2022, at 06:03. WHO Coronavirus (COVID-19) Dashboard. When side effects occurred among participants, the most common reactions were: Injection-site symptoms, including pain, swelling, and redness. Responses to Q4 demonstrate that patients are increasingly less confident that the progression of their glaucoma remains stable. J Fr Ophtalmol. Optic neuritis is an inflammation affecting the optic nerve that sends signals from the back of the eye to the brain. Copyright 2022 Indiadotcom Digital Private Limited. Healthiest Communities is an interactive destination developed by U.S. News & World Report for consumers and policymakers. In rare cases, some patients whove received the flu vaccine experienced mild symptoms like eye redness, eye pain and blurred vision. urinary calculi, adrenal nodule, and glaucoma. But the study was limited. Spencer Cox said on Friday that he plans to sign a measure that would effectively ban abortion clinics from operating in the state. Angle-closure glaucoma; COVID 19 infection; hyponatremia. PA-5108 is under clinical development by PolyActiva and currently in Phase II for Open-Angle Glaucoma. 2021;139(7):e212471. doi:10.1016/j.jfo.2021.06.001, Phylactou M, Li JPO, Larkin DFP. The rare nerve condition Guillain-Barre syndrome has also been seen in about 8 in every 1 million adults vaccinated with the J&J vaccine. COVID-19 vaccinations are highly effective at preventing severe, symptomatic disease[2][3][4]. Suspected patients should be referred to the ophthalmology department. The measles vaccine is the best option for preventing the disease and, therefore, preventing measles-related vision problems. Cases of scleritis, episcleritis, and multiple evanescent white dot syndrome, following COVID-19 vaccination have also been reported[9].. Careers. 2021;47(11):625-628. doi:10.1097/ICL.0000000000000840, Wasser LM, Roditi E, Zadok D, Berkowitz L, Weill Y. Keratoplasty Rejection After the BNT162b2 messenger RNA Vaccine. Very rarely, a blood-clotting condition called TTS can occur in the weeks following a Johnson & Johnson vaccination. The three FDA-approved COVID vaccines that are currently being administered have proven to be largely effective and safe, both in clinical trials and the real world. The number of vaccine doses you need depends on your age and the type of vaccine you receive. doi: 10.1097/IOP.0000000000002161. Face Masks COVID-19 Test Kits COVID-19 Medication Immune Support Book your COVID-19 Vaccine COVID-19 Vaccine Digital Record. The vaccines are not safe, because they were developed so fast. In addition to chronic eye conditions, there are also eye emergencies for which patients should seek immediate medical care even as the coronavirus pandemic peaks, says Dr. Alan Kozarsky, an ophthalmologist and eye surgeon at Eye Consultants of Atlanta. Today, her vision has recovered some, "but it's uncertain whether she will have permanent damage because of the delay," Murray says. The federal government is providing FDA-authorized COVID-19 vaccines free to all people living in the United States, regardless of their immigration or health insurance status. Dosage. Find an eyecare professional and book online in minutes! The https:// ensures that you are connecting to the An analysis of the patients' medical records revealed no evidence that mRNA COVID-19 vaccination had increased the type, frequency, or severity of immune-related side effects, such as inflammation in the lungs or colon, researchers found. the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in The case offers proof that SARS-CoV-2 can also infect ocular tissues in addition to the respiratory system. COVID-19 Vaccination Requirements. Eye. sharing sensitive information, make sure youre on a federal
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