Ophthalmic Manifestations of COVID-19: A Retrospective Study on Prevalence, Characteristics, and Clinical Implications

Background: The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, has had far-reaching implications beyond the respiratory system. Mounting evidence suggests that COVID-19 can impact various organ systems, including the eyes. This study aimed to elucidate the prevalence, characteristics, and clinical implications of ophthalmic manifestations in patients diagnosed with COVID19. Methods: This retrospective study analyzed data from electronic medical records of adult patients hospitalized with COVID-19 between March 1, 2020, and December 31, 2020, at a large tertiary academic medical center. Ophthalmic manifestations, including conjunctivitis, dry eye symptoms, ocular pain, epiphora, ocular redness, and visual disturbances, were identified and examined for their prevalence, onset, duration, and associations with COVID-19 severity and systemic symptoms. Results: Among 342 patients included in the study, 106 (31.0%) experienced at least one ophthalmic manifestation during their COVID-19 illness. Conjunctivitis was the most common manifestation in 62 patients (18.1%), followed by dry eye symptoms in 38 patients (11.1%), ocular pain/discomfort in 27 patients (7.9%), epiphora in 19 patients (5.6%), ocular redness in 14 patients (4.1%), and visual disturbances in nine patients (2.6%). Ophthalmic manifestations were significantly associated with severe COVID-19 illness (42.9% vs. 26.7%, p = 0.003) and the presence of systemic symptoms such as fever, cough, and dyspnea. The median time of onset was six days, and the median duration was 10 days. Conclusions: Ophthalmic manifestations are prevalent in COVID-19 patients, particularly in those with severe illness and systemic symptoms. The study highlights the importance of recognizing and managing ocular symptoms in affected individuals and underscores the multifaceted nature of COVID-19, necessitating interdisciplinary collaboration for comprehensive patient care.