The COVID-19 pandemic has impacted many aspects of health and daily life. As we learn more about this novel coronavirus, researchers are discovering that it can affect more than just the lungs. Some studies have shown that COVID-19 may also affect the eyes and vision in some patients. In this article, we’ll explore what the research says so far about whether COVID can affect your eyes.
Can COVID-19 cause conjunctivitis?
Conjunctivitis, also known as pink eye, is inflammation of the conjunctiva – the thin, transparent layer of tissue that covers the white part of the eye. Conjunctivitis causes redness, itching, and watery discharge from the eyes.
Several studies have found that conjunctivitis can be a symptom of COVID-19 in a small percentage of patients. A meta-analysis of over 6000 COVID-19 patients found that 3% experienced conjunctivitis. Other studies have found rates between 1-3%.
It’s still unclear whether SARS-CoV-2, the virus that causes COVID-19, directly infects the conjunctiva. More research is needed to determine how conjunctivitis develops in COVID-19 patients.
The American Academy of Ophthalmology recommends that people who develop pink eye with no known cause be evaluated for COVID-19. However, conjunctivitis is not a primary symptom of the disease – it occurs much less frequently than fever, cough, and shortness of breath.
Can COVID-19 cause other eye issues?
In rare cases, COVID-19 may be associated with other eye problems:
Dry eyes
Some COVID-19 patients report symptoms of dry eye, including irritation, redness, and blurry vision. Dry eyes may be caused by inflammation or irritation of the tear-producing glands.
Pinkeye (conjunctivitis)
As mentioned earlier, pinkeye can sometimes be a symptom of COVID-19. Viruses are a common cause of infectious pinkeye.
Light sensitivity
Increased light sensitivity, also known as photophobia, has been reported in some cases. Doctors are still investigating the potential causes.
Retinal changes
A few studies have found retinal changes in the eyes of some COVID-19 patients. These changes include blot hemorrhages, microaneurysms, and cotton wool spots. More research is needed to determine the significance of these findings.
Optic neuritis
There are a small number of reports of optic neuritis (inflammation of the optic nerve) and optic ischemia (restricted blood flow to the optic nerve) in COVID-19 patients. These conditions can sometimes cause temporary or permanent vision loss.
Blepharitis
Blepharitis, or eyelid inflammation, has also been reported in association with COVID-19 in some cases.
These other eye manifestations appear to be relatively rare overall in COVID-19 patients. The exact mechanisms by which COVID-19 may affect the eyes are still under investigation.
Who is at risk for COVID-19 related eye problems?
Based on current evidence, patients who already have eye conditions may be more likely to experience vision issues related to COVID-19. For example:
– Those with conjunctivitis as a symptom are more likely to have moderate-severe COVID-19 overall.
– Patients reporting eye symptoms tend to have higher inflammatory markers, indicating more severe systemic inflammation.
– Retinal findings are more common in hospitalized patients who are critically ill.
There isn’t enough evidence yet to determine if age, gender, or race is linked to increased risk of eye complications. This is an area requiring further study.
Can wearing glasses provide protection?
Some researchers have speculated that wearing eyeglasses may help protect against COVID-19, because glasses create a barrier that could block respiratory droplets from entering the eyes.
So far, there is no direct evidence to support this hypothesis. However, wearing safety glasses or goggles is recommended for health workers caring for COVID-19 patients, as part of full personal protective equipment (PPE).
For the general public, the protective effect of glasses against COVID-19 is still theoretical. More targeted research would be needed. The best proven methods of protecting the eyes remain:
– Not touching the eyes with unwashed hands
– Practicing social distancing
– Wearing a face mask around others
Can COVID-19 spread through tears?
Research on whether or not COVID-19 can spread through tears is still in the early stages.
One small study found that some COVID-19 patients had the virus present in their tear or conjunctival fluid samples. However, the study did not demonstrate that the virus present in tears was infectious.
Some other studies using animal models have shown mixed results on whether the virus can replicate in tears.
Currently, there are no proven reports of COVID-19 spreading through tears. More research is needed to better understand the potential risks.
The American Academy of Ophthalmology states that the risk of virus transmission through tears is thought to be low. But it’s recommended that ophthalmologists wear protective gear during exams and procedures that generate aerosols.
Can COVID-19 lead to vision loss or blindness?
There have been a few case reports of temporary or permanent vision loss associated with COVID-19. Vision loss appears to be a relatively rare complication overall.
Reported vision issues include:
– Optic neuritis or nerve damage causing vision loss
– Ischemic optic neuropathy from reduced blood flow to the optic nerve
– Severe retinal damage
– Cortical vision impairment, suggesting possible damage to the visual centers in the brain in patients with neurological symptoms
However, the connections between COVID-19 and vision loss are still not fully understood. Not all these cases have been conclusively linked to the virus. Significant vision problems occur mainly in severely ill patients.
The American Academy of Ophthalmology recommends urgent evaluation for any patients reporting new vision loss that can’t be explained by other causes. Early treatment of certain eye conditions could help prevent permanent damage.
Can the virus remain in the eyes after recovery?
A small percentage of patients have continued to test positive for the virus in eye fluid samples, even after recovering from COVID-19.
Results from several studies show:
– In one study, 27% of patients had positive results in tear samples taken 1-3 weeks after diagnosis.
– Another study found SARS-CoV-2 RNA in 5.2% of conjunctival swabs of recovered patients vs. 16.7% of samples from hospitalized patients.
– A third study detected the virus in tears in about 1.1% of recovered patients.
However, presence of viral RNA does not necessarily indicate active, replicating virus is present. Patients with positive eye samples were not contagious after recovery in most cases.
The results suggest the eyes could be a reservoir for lingering viral genetic material in some people. But this doesn’t appear to pose a significant risk for transmission after recovery. The virus may remain present at low levels, but likely becomes inactivated over time.
Preventing COVID-19 related eye complications
While COVID-19’s effects on the eyes still aren’t fully defined, there are steps you can take to keep your eyes as healthy as possible:
– Don’t touch or rub your eyes with unwashed hands.
– Avoid touching your face as much as possible.
– Wash your hands frequently with soap and water.
– Follow social distancing guidelines.
– Seek prompt medical care if you develop any new eye symptoms or vision changes.
– Tell your eye doctor if you’ve had suspected or confirmed COVID-19.
– Consider telemedicine visits for non-urgent eye care issues to limit potential exposure.
– Wear approved goggles or a face shield if you’ll be in close contact with infected patients.
Protecting your overall health is also important – stay up to date on vaccinations, get enough rest, manage any medical conditions carefully, and maintain a healthy diet and exercise level.
By taking sensible precautions, the risk of eye issues related to COVID-19 appears low for most people. Those with existing eye conditions or who are severely ill with COVID-19 may have higher risks that require monitoring and rapid treatment. Research is ongoing to better define the relationship between this new virus and the eyes.
Summary
COVID-19 is still a novel disease, but here’s what we know so far about its potential effects on the eyes:
– Pink eye (conjunctivitis) affects about 1-3% of COVID-19 patients and can be a symptom of infection. Other relatively rare eye manifestations have also been reported.
– Those with pre-existing eye disease appear more prone to vision issues with COVID-19, especially if severely ill.
– Wearing glasses may offer some protection against infection but isn’t proven. Safety goggles should be worn by health workers performing certain tasks.
– SARS-CoV-2 may rarely persist in the eyes after recovery, but this doesn’t appear highly contagious.
– Serious vision loss with COVID-19 is possible but not common. Seek urgent care for any unexplained new vision problems.
– Preventive measures like handwashing, face masks, and social distancing can help lower the risks of viral exposure through the eyes.
The interactions between COVID-19 and the eyes are complex. More research is needed, but protective steps can be taken in the meantime. People with eye conditions should be especially vigilant and discuss any concerns with their doctor.
