Objective: Available in both oral and intravenous formulations, bisphosphonates are the most frequently prescribed medications for the treatment of osteoporosis. Their side effect profile is well-established, with gastrointestinal involvement being the most common reason for bisphosphonate cessation by patients. Though ocular side effects can occur, episodes of ocular inflammation are rarely reported. However, the current case describes a patient who experienced two episodes of ocular inflammation after separate exposures to bisphosphonates.

Case presentation: A case of a 64-year-old female with osteoporosis who experienced episcleritis and uveitis after receiving oral and intravenous bisphosphonates is reported. Her initial occurrence of episcleritis was originally thought to be related to viral exposure. However, she then developed uveitis two days after receiving intravenous zoledronate.

Conclusions: This case, therefore, highlights the importance of discussions with patients around less common side effects of oral and intravenous bisphosphonates to allow for earlier identification and treatment of episodes of ocular inflammation.