Eye problems and COVID-19

COVID-19 is a new virus
COVID-19 is a new virus that caused the whole world to go into a turmoil. The infection, caused by a coronavirus named SARS-CoV-2, was first recognized in Wuhan, China in December 2019 and has since spread like wildfire, killing more than 300,000 people worldwide as of May 2020. The first theory that a virus came from a Wuhan seafood market failed to confirm, as it was later found that many of the first people who got sick has not eaten any food from this market. There is a theory that this corona virus, which is common in nature and known to infect bats, jumped into a human-infecting form. There is also a theory that COVID is a genetically altered coronavirus that originated in the lab of the Wuhan institute, which worked exactly with viruses like this one (experimenting with the possibility of such virus of infecting humans). Why is it important to know about the COVID-19, or more appropriately named SARS-CoV-2 virus? The answer is simple – if you know what that virus does and how it transmits, you will be able to understand how to prevent this infection, and what to expect if you get sick with it.
virus and scientists
So far here are the facts about novel COVID coronavirus:
  • It is transmitted mainly by respiratory route – people coughing or sneezing in poorly ventilated crowded spaces. While it can remain on the surface for hours, the virus was not found to be infectious in most cases. Other routs of transmission were suspected but were not confirmed.
  • It has 3-7 days incubation period (when you are sick but no symptoms yet)
  • Sickness generally lasts 1-2 weeks if a person does not develop severe form or complications
  • A person is infectious (can get others sick) only 3 days prior to symptoms and 7 days after being symptomatic
  • Kids in general rarely get sick with covid. The relative probability of transmission from an infected child compared with that from an adult is not well understood.
  • Elderly people in the nursing homes affected the most severely and frequently die from COVID-19
How does COVID affect the vision? We do not know much about this virus and scientists and doctors are still debating how much damage it can do to the body. Here are the main systems that seem to be affected most by this coronavirus:
  • Respiratory system
  • Cardiovascular system
  • Any body organ that is already inflamed or not working properly (diabetes, obesity, high blood pressure can damage all body)
prevent of COVID
Here are the symptoms COVID causes in adults:
  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea
As you can see vision loss is not the main symptom of COVID infection in adults, although a conjunctival irritation is almost the main symptom in children. The most significant ocular symptom experienced by those suffering from coronavirus disease 2019 (COVID-19) was sore eyes, according to new research published in BMJ Open Ophthalmology. Unfortunately, the most significant vision problem comes from another phenomenon caused by pandemic – being locked at home and no exercise. While we are in a pandemic situation with no vacations or normal entertainment, the time is spent sitting with the computers and phones. As this is extremely unhealthy for the body and eye blood circulation and ocular muscles, there are many long-term problems of the vision that could affect adults and kids indirectly due to COVID-19.
symptoms of the eye
Are there any symptoms of the eye with corona virus infection? Yes. Even they will not be the main reason you will suspect you have COVID-19, there are problems with eyes in some people. One study conducted in China found that among children diagnosed with COVID-19, the most common ocular symptoms included conjunctival discharge, eye rubbing, and conjunctival congestion.


patients with ocular abnormalities
In a study of the COVID patients in China, clinicians found that in 38 patients with COVID-19, 12 patients had ocular manifestations, such as epiphora, conjunctival congestion, or chemosis, and these commonly occurred in patients with more severe systemic manifestations. Reverse transcriptase–polymerase chain reaction results were positive for severe acute respiratory syndrome coronavirus 2 in 28 nasopharyngeal swabs and 2 conjunctival swabs, and more significant changes in blood test values appeared in patients with ocular abnormalities. Just like any virus of the corona family, SARS-CoV-2 can affect all mucus membranes and cause the eyes to be:
  • Red. As a part of coronavirus infection that eyes might become irritated and red. This is most common in kids, who have viral conjunctivitis as a COVID-19 symptom.
  • Swollen. The eyelids and internal conjunctiva may look swollen and feel like “something is inside”.
  • Itchy. If the eyes also become itchy but there are no fever or cough, you or your child may be experiencing an eye allergy. Make sure you think about all possible other causes of the red itchy eyes other than COVID.
COVID eye symptoms
Here what another larger study found:
  • The most reported COVID-19 symptoms were dry cough (66%), fever (76%), fatigue (90%) and loss of smell/taste (70%).
  • The 3 most common ocular symptoms were photophobia (18%), sore eyes (16%) and itchy eyes (17%).
  • The frequency of sore eyes was significantly higher (P = .002) during COVID-19 state (16%) compared with pre-COVID-19 state (5%).
  • 81% of participants reported to have experienced ocular symptoms within 2 weeks of other COVID-19 symptoms, and 80% reported they lasted for less than 2 weeks.
  • There was no significant difference in the duration of eye symptoms and the other symptoms of COVID-19 (P = .147)
  • There was no significant effect of different age groups on ocular symptoms (P <.05), or significant difference between males and females (P >.05)

How the Infection Spreads

symptom onset
Although several experimental studies have cultured live virus from aerosols and surfaces hours after inoculation, the real-world studies that detect viral RNA in the environment report very low levels, and few have isolated viable virus. Strong evidence from case and cluster reports indicates that respiratory transmission is dominant, with proximity and ventilation being key determinants of transmission risk. In the few cases where direct contact or fomite transmission is presumed, respiratory transmission has not been completely excluded. Infectiousness peaks around a day before symptom onset and declines within a week of symptom onset, and no late linked transmissions (after a patient has had symptoms for about a week) have been documented. The virus has heterogeneous transmission dynamics: Most persons do not transmit virus, whereas some cause many secondary cases in transmission clusters called “superspreading events.” Evidence-based policies and practices should incorporate the accumulating knowledge about transmission of SARS-CoV-2 to help educate the public and slow the spread of this virus.

Seeing Your Doctor

telemedicine is a great way
This is a controversial topic if the symptoms are not severe. Remember, a person is still infectious even if the symptoms are mild. So, the most recent advice was to stay at home and just treat COVID as any upper respiratory viral illness if there are no dangerous symptoms. Most of the COVID eye symptoms are not severe, and can be treated with topical compress to relieve pain. If you have a light sensitivity and headache, it is helpful to stay in bed and close the window shades. Try not to use electronic devices as it can increase the eye strain and cause more eye symptoms. Also, telemedicine is a great way to get a good medical advice without infecting people – a video appointment can help you deal with mild symptoms. You can read an information about self-isolation, and how to keep your family and friends from getting COVID from you. What are severe signs that you need to see a doctor of even go the ER? Here are severe symptoms of COVID:
  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face
If you or your loved one experiencing any of these symptoms with COVID you need to call 911 and alert personnel that you or your relative is infectious.

How to Protect Your Eyes

risk of transmission via the ocular
The risk of transmission via the ocular surface remains likely low, though it is inarguably present. Contact lenses. It is crucially important to take proper care of the contacts. Make sure that you do not leave the lenses overnight, and use clean fresh storing solutions. Wash hands before you touch your eyes! It is important to remember, especially if the mask is irritating your skin under the eyes – many people forget about the infection and rub the eyes while at the store or other public places. Do not change the contacts outside the house if you are not sure if a transmission can happen. If the lens fell out – discarding it is the best idea. Wear glasses. Close contact with infected person is the main way the COVID transmits. So, if you are in the close unavoidable contact with the person who might sneeze or cough, its best to wear a face shield or glasses. Don’t forget that it is best to also wear gloves so you will not transmit viral particles from a shield or glasses by touching them (and then touching your nose or mouth!). it is not recommended to wear the eye protection in low-risk situations and outdoors. Few professions are definitely at risk, such as dental clinics and ear-nose-throat examinations in the other medical settings. Taking care of a relative who is sick with COVID is also a high-risk for infection situation – you should consult your doctor about best protection. Don’t rub your eyes. While clean hands cannot transmit the virus, it is certainly a possibility if you just touched a fresh cough droplet from a COVID-infected person on a cart handle or a restroom door handle. Stock up eye medication. If you have an eye condition such as glaucoma or eye allergy, it is important to have sufficient quantity of the eye drops. Don’t wait until the last moment to call your doctor, as the office hours may be limited due to pandemic.

Can COVID cause temporary or permanent damage to your eyes?

As we discussed above, a COVID virus can cause only temporary eye symptoms and does not affect the vision, while a pandemic situation leading to an unhealthy lifestyle definitely can damage your vision. It is much better to take care of your eyes and go to the follow up appointments with your doctor on time. There is no reason to be scared of the doctor’s clinics – these are professionals who know the best how to control infections. Do not forget about daily health – exercise as much as you can, eat food rich with vitamins and do not overstrain your eyes with electronics!
daily health – exercise


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Allergist and Immunologist, Integrative medicine