COVID-19 and the eye: a review (original) (raw)

Frequency of Ocular Symptoms in COVID-19 Patients

Journal of Rawalpindi Medical College, 2023

Objective: To determine the frequency of ocular symptoms in COVID 19 patients and its association with systemic symptoms in active COVID 19 patients. Methods: This is a cross sectional observational study of laboratory confirmed COVID-19 patients who were admitted in isolation wards for a period from Dec 16, 2020 to Jan 15, 2021. A structured form was used to extract the data from electronic medical records. Data collected included sociodemographic characteristics, presenting symptoms, systemic signs and symptoms, ocular symptoms, past medical history, RT-PCR and chest radiographic findings. Results: A total of 44 patients (30 (68.2%) males and 14 (31.82%) females) were admitted to the isolation wards during the study period. The mean age (+ SD) age was 55.75 + 14.53 with median range 57.50 (14-92). Age <30 years i.e. 4.5%, 30-50 i.e. 27.3% and >50 i.e. 68.2%.Ocular symptoms were present in 17 patients (38.6%). Conclusion: We conclude from our study that Ocular symptoms ...

COVID-19 AND THE HUMAN EYE – CONJUNCTIVITIS A LONE COVID-19 FINDING - A case-control study

Medical Principles and Practice

Background: The worldwide sudden appearance and drastic increase in the number of infected cases with the severe acute respiratory syndrome-Coronavirus 2 (SARS-CoV-2) determined the World Health Organization to declare it as a pandemic situation. The ‘Corona Virus Disease 2019’ (COVID-19) has varied clinical manifestations, from asymptomatic to severe cases, and conjunctivitis, seems not only to be one of them, but sometimes found to be lone initial symptom present. Aim and method: The aim was to identify the prevalence of conjunctivitis as the first symptom in COVID-19 patients, in a primary healthcare unit. A retrospective study was conducted analyzing the presenting complains/symptoms and results of COVID-19 confirmatory tests. Results: Out of the 672 cases that were sent for RT-PCR testing only 121 (18%) were found to be positive. Among this 2.67% of patients who had both conjunctivitis and COVID-19, 77.77% of patients had unilateral eye affected while 22.22% had bilateral conju...

Ocular Symptoms In COVID-19 Infection: A Survey Study

Investigative Ophthalmology & Visual Science, 2021

Background: Coronavirus disease 2019 (COVID-19) systemic symptoms and sequelae have been studied extensively, but less is known about the characterization, duration, and long-term sequelae of ocular symptoms associated with COVID-19 infection. The purpose of this study was to analyze the frequency, spectrum, and duration of ocular symptoms in participants with COVID-19 infection treated in inpatient and outpatient settings. Methods: A retrospective electronic survey was distributed to NIH employees and the public who reported testing positive for SARS-CoV-2. The anonymous survey collected information on demographics, past ocular history, systemic COVID-19 symptoms, and ocular symptoms. Results: A total of 229 (21.9% male and 78.1% female, mean age 42.5 ±13.9) survey responses were included. Ocular symptoms were reported by 165 participants with a mean of 2.31±2.42 symptoms. The most commonly reported ocular symptoms were light sensitivity (31.0%), itchy eyes (24.9%), tearing (24.9%), eye redness (24.5%), and eye pain (24.5%). Participants with ocular symptoms had a higher number of systemic symptoms compared to participants without ocular symptoms (mean 9.17 ± 4.19 vs 6.22 ± 3.63; OR: 1.21; 95% CI: 1.11-1.32; p<0.001). Ocular symptoms were more common in those who reported a past ocular history compared to those who did not (81.8% vs 67.1%; OR: 2.17; 95% CI: 1.08-4.37; p=0.03). Additionally, the onset of ocular symptoms occurred most frequently at the same time as systemic symptoms (47.5%), and 12.6% reported symptoms lasting ≥14 days. Conclusions: Ocular surface-related symptoms are the most frequent ocular manifestations, and systemic disease severity is associated with the presence of ocular symptoms. Additionally, our results show that ocular symptoms can persist post-COVID-19 infection. Further work is needed to better understand ocular symptoms in COVID-19 and long-term sequelae.

Evaluation of ocular symptoms in COVID-19 subjects in inpatient and outpatient settings

International Ophthalmology

Purpose Evaluation of subtle ocular involvement and clinically significant conjunctivitis symptoms in a group of patients with COVID-19 in outpatient and inpatient settings. Method Overall, 1083 patients infected with SARS-CoV-2 were recruited as subjects. Patients were divided into inpatients (group 1, n = 371) and outpatients (group 2, n = 712). Demographical and general medical data included age, sex, and comorbidities. Patients whose diagnosis was confirmed by reversetranscriptase polymerase chain reaction (RT-PCR) were called by phone, and their chronic ocular disease, previous ocular surgery, ocular medication, contact lens wear and ocular irritation symptoms were queried during the active disease period. Results The mean age of the patients was 44.2 ± 16.5 (19-97) years; 635 (58.6%) were male, and 448 (41.4%) were female. Comorbidity, chronic ocular disease, ophthalmic medication and previous ocular surgery rates were significantly higher in group 1 (p \ 0.05), while contact lens wear was not significantly different between groups. The main complaints received from patients were sore eye or burning sensation, foreign body sensation, itching and red eye and were significantly higher in group 1. Clinically significant conjunctivitis symptoms, such as red eye, ocular discharge and eyelid edema, were observed in 28 patients (2.6%), with 14 (3.8%) patients in group 1 and 14 (2%) patients in group 2. Conclusion Clinically significant conjunctivitis symptoms were detected in 28 subjects in the inpatient and outpatient groups. As systemic findings of

Survey of Direct and Indirect Effects of COVID-19 on Eyes and the Common Ocular Manifestations

2021

PurposeOcular manifestations were reported in many recent observations that studied either the effect of COVID-19 directly on eyes or of face mask use. Hence, this study aimed to investigate the effect of COVID-19 on the eyes and make a clear comparison of its direct and indirect effect from face mask-wearing.MethodsThis was a cross-sectional study of both written and web-based questionnaires, distributed among a group of COVID-19 patients and a matched control group, the questionnaire consisted of common demographic data, COVID-19 infection history and its symptoms, focusing on ocular symptoms and the presence of conditions related to or cause eye symptoms. As well as the use of face masks that were assessed in terms of the complained ocular manifestationResultsOf 618 participants, 252 had COVID-19 and 366 never had COVID-19. Ocular manifestation among COVID-19 incidence was 44%, significantly higher than non-infected participants’ incidence (35.8%), adjusted odds ratio, 95% confid...

A study of ophthalmic co-morbidities in mild to moderate cases of COVID- 19 infection

Indian Journal of Clinical and Experimental Ophthalmology, 2022

To study the ophthalmic co-morbidities and post-COVID ophthalmic complications in mild to moderate COVID positive patients. Materials and Methods: This was a questionnaire based prospective longitudinal study conducted between August 2020 and December 2020. In the first phase, an ophthalmologist in personal protective equipment (PPE) physically visited the patients and a pre-designed structured questionnaire regarding any ophthalmic complaints was filled and scoring was done later. In the second phase, the patients were telephonically interviewed after 3-6 months of their discharge from the hospital, regarding the development of ocular symptoms for which they needed to consult an ophthalmologist and the treatment taken was noted. Results: 9% of the total 77 patients included in the study reported severe symptoms (scores between 17-24/24). On comparing the mean questionnaire scores (out of 24) it was seen that more severe ophthalmic complaints were seen in patients aged >= 50 years than <50 years (11.35 vs 5.75, p<0.05), moderate category than mild category patients (11.70 vs 3.63, p<0.05), patients with systemic co-morbidities than those who had none (11.48 vs 4.04, p<0.05) and in patients who later needed to consult an ophthalmologist due to development of one or more complications than those who did not.(13.27 vs 6.63, p<0.05). Post-COVID complications were seen in 27 patients (35%). They included progression of pre-existing ocular disease like cataract, glaucoma, diabetic and hypertensive retinopathy, and new diagnosis of diabetic and hypertensive retinopathy and HCQ-related maculopathy. Conclusion: Ocular co-morbidities should be looked for in every COVID patient. Those at higher risk of developing complications, should undergo a detailed ophthalmic examination after they are discharged from the isolation wards. Hospitals need to work on capacity building and/or look for alternatives, like telemedicine, to ensure timely eye care to all patients. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Ophthalmology-focused publications and findings on COVID-19: A systematic review

European Journal of Ophthalmology, 2021

To summarize COVID-19 research endeavors by ophthalmologists/researchers in terms of publication numbers, journals and author countries, and to detail key findings. Methods: The LitCovid database was systematically reviewed for ophthalmology-focused COVID-19 articles. The quality of the evidence was assessed for articles investigating conjunctivitis in COVID-19 patients. Results: There were 21,364 articles in LitCovid on June 12, 2020, of which 215 (1%) were ophthalmology-focused. Of articles on COVID-19 transmission, 3.3% were ophthalmology-focused. Ophthalmology-focused articles were published in 68 journals and originated from 25 countries. The top five countries publishing ophthalmology-focused articles (China, India, United States of America, Italy, and United Kingdom) produced 145/215 (67%) articles. A total of 16 case reports/ series from eight countries reported that conjunctivitis can be the initial or the only symptom of COVID-19 infection. Conjunctivitis may occur in the middle phase of COVID-19 illness. A total of 10 hospital-based cross-sectional studies reported that between 0% and 31.6% of COVID-19 patients have conjunctivitis or other ocular conditions, with a pooled prevalence of 5.5% reported in a meta-analysis. Viral RNA was detected in conjunctival swabs of patients with and without ocular manifestations, after resolution of conjunctivitis, after nasopharyngeal swabs turned negative and in retina of deceased COVID-19 patients. Conclusion: Within 3 months of declaring the COVID-19 pandemic, 215 ophthalmology-focused articles were published in PubMed, concentrating on disease manifestations and transmission. The reported presence of conjunctivitis or other ocular conditions in COVID-19 patients is varied. Clinicians should be alert for ocular involvement in COVID-19 infections and possible ocular transmission even in patients without ocular symptoms.

OCULAR MANIFESTATIONS OF COVID 19

Ifemed Journal, 2022

SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2) is a coronavirus that causes COVID-19 (coronavirus disease 2019) with mild to severe respiratory illness. It is a highly contagious disease transmitted via respiratory droplets and other routes still being investigated either through a direct or indirect contact with infected people or contaminated surfaces. It is well known that corona viruses (CoVs) can cause a variety of ocular pathologies in animals, including conjunctivitis, anterior uveitis, retinitis, and optic neuritis, many o f which are severe. However, there is no evidence to support the presence of the SARS-CoV-2 in the eye tissue of asymptomatic patients, even if the symptomatic incidence is low. COVID-19 has spread throughout the continents and has become a global threat to public health as it posed the risk of rapidly overloading health care systems and causing grave mortality worldwide. As a result of this, the World Health Organization (WHO) on March 11, 2020 declared coronavirus a global pandemic. While diagnostic and therapeutic efforts have been focused on respiratory complications of the disease, several studies have described a few cases with initial ocular symptoms followed by systemic symptoms of the disease. SARS-CoV-2 RNA has been found in tears of the infected patients, and reports suggest that the ocular surface could serve as a portal of entry and a reservoir for viral transmission. Although, COVID-19 has been clinically associated with mild conjunctivitis, which can be the first and only symptom of the disease, subtle retinal changes like hyperreflective lesions in the inner layers on optical coherence tomography (OCT), cotton-wool spots, and microhaemorrhages have also been reported. It has also been associated with an increased incidence of systemic diseases like diabetes mellitus and Kawasaki disease, which are particularly relevant for ophthalmologists due to their potentially severe ocular manifestations.

COVID-19 and the eye: how much do we really know? A best evidence review

Arquivos brasileiros de oftalmologia, 2020

To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limi...

Eye in COVID-19: A Brief Review

Pakistan Journal of Ophthalmology

This is a brief review covering the currently available literature on ocular manifestations of COVID-19, andprevention strategies for ophthalmologists. A literature search was carried out of Pubmed, Google Scholar andWHO database of publications on COVID. Keywords used in the search were eye, ocular manifestations,ophthalmology, COVID-19, nCoV-2019, and coronavirus disease. All available articles were reviewed and thosepertinent to the study topic were included. Considering the dearth of information available, ophthalmology journals were also searched separately for relevant articles. Major ocular manifestation of COVID reported in literature is red eye, which usually presents before the onset of respiratory symptoms. Since the eye can be a possible transmission route for SARS-CoV-2, infection control measures should be undertaken by ophthalmologists, including use of personal protection equipment and eye/face covering. A framework for structuring ophthalmological services during th...