Coronavirus and the Eye

As we learn more about the novel coronavirus and the disease that it causes (COVID-19), we are learning about the various parts of the body that it can affect. Our eyes may play a key role in both the spread and prevention of the new coronavirus outbreak. 

What eye symptoms does coronavirus cause?

COVID-19 can cause a viral conjunctivitis (or “pink eye”) in a small subset of patients.  Conjunctivitis is an inflammation of the clear ‘skin’ that covers the eyeball and presents as a red, “wet and weepy” eye. It can often affect one eye and then the other eye a few days later.

Several published reports suggest that conjunctivitis occurs in coronavirus infection either as an early sign of infection or during hospitalization for severe Covid-19 disease. A study, published in the New England Journal of Medicine, looked at patients across multiple hospitals in China with a confirmed diagnosis of Covid-19 and found that a little less than 1% of them had conjunctivitis. In a retrospective case series published in JAMA Ophthalmology, about a third of clinically confirmed hospitalized cases of Covid-19 in China had ocular findings. In a story from CNN, a registered nurse in a nursing home in Washington state with a large Covid-19 outbreak reported that red eye was a common early sign in elderly patients who then became sick with COVID-19.

While conjunctivitis can occur in Covid-19, red eyes alone are not enough to diagnose coronavirus infection. A new conjunctivitis diagnosis may trigger your doctor to ask other screening questions to assess your risk of having coronavirus.

In addition to conjunctivitis, a recent opinion piece in The New York Times tracked various Google search terms most related to Covid-19 disease and found an uptick in the number of internet searches for eye pain. The four most common Google searches were loss of smell, fever, chills and then eye pain. The search for “my eyes hurt” was found to be highest in parts of the country that have high Covid-19 rates. It was also found to be completely separate from conjunctivitis. Larger dataset and more time will help us know whether eye pain is truly an early symptom of Covid-19 disease.

Can I get coronavirus through my eyes?

It is believed that the coronavirus is transmitted mainly through respiratory droplets (i.e. when someone coughs or sneezes) that infect mucous membranes (mouth, nose, eye). Since the eye is a mucous membrane, if a droplet enters the eye or lands on your hand and you touch your eye, this can transmit the virus. Experts are still uncertain if you can contract the virus by touching a surface with virus particles on it and then touching your mouth, nose, or eyes.

Various studies have looked at whether the virus can be spread through tears. Studies have suggested that some Covid-19 patients who have conjunctivitis have infectious viral particles in their tears but that this is rare. To date, infectious virus has not yet been cultured from the conjunctiva of any Covid-19 patient. Furthermore, the risk of transmission of the new coronavirus through tears is low, according to a new study published in Ophthalmology . Researchers tested tear samples collected from patients with COVID-19 in Singapore.

Does coronavirus affect my vision?

There is no evidence that coronavirus causes any loss of vision. While patients with viral conjunctivitis (from ANY virus) can experience some blurring of vision, this is temporary and causes no lasting visual impairment.

Are my eye symptoms allergies or viral conjunctivitis?

Many symptoms of allergies and viral conjunctivitis overlap and it can be difficult to tell the two diagnoses apart. Allergies tend to be seasonal (more often occurring in Spring) and cause itchy, watery, red eyes. Both eyes are affected relatively evenly from allergies. In viral conjunctivitis (or pink eye), the most common symptoms are redness, burning, itching and watering. These symptoms are frequently accompanied by an upper respiratory tract infection (runny/stuffy nose, throat pain). Patients also frequently describe that symptoms start in one eye and then move to involve the other eye days later. Patients may have sick contacts at home or young kids in daycare. It is also more common in viral conjunctivitis to have some mucous drainage and crusting of the lashes.

Ultimately, the treatment for both entities is the same. We recommend artificial tears, cold compresses, and to wash your hands frequently with soap and water. If you are having symptoms, schedule an appointment with one of our expert physicians.

What can I do to prevent spread of coronavirus?

Clean your hands often

• Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place, eaten, used the restroom, blown your nose, coughed or sneezed.
• Avoid touching your eyes, nose and mouth as much as possible, but especially with unwashed hands.

Reduce your exposure

• Avoid close contact with people who are sick.
• Stay home if you’re sick — except to get medical care.
• Wear a cloth mask in public

Cover coughs and sneezes

• Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
• Throw used tissues in the trash.
• Immediately wash your hands with soap and water for at least 20 seconds.
• Wear a face mask that covers your mouth and nose

Clean and disinfect surfaces

• Clean and disinfect high-touch surfaces daily in household common areas

In addition to these recommendations, The American Academy of Ophthalmology recommends contact lens wearers switch to glasses temporarily as a way to reduce their risk of contracting the virus that causes Covid-19. Contact lens wearers touch their eyes more often than those wearing glasses.