The Ocular Manifestations of COVID-19 Through Conjunctivitis

There is growing evidence that the novel coronavirus (SARS-CoV-2) is capable of transmission through the eye. Research suggests that infection by SARS-CoV-2 can produce an inflammation of the conjunctiva, which leads to redness and itchiness of the eyes. Furthermore, viral particles have been detected in conjunctival secretions of SARS-CoV-2 patients who present with conjunctivitis and is likely another mode of transmission. A 53-year-old male presented with a complaint of left eye irritation and upper eyelid swelling for the past 24 hours. The right eye had mild irritation but no lid swelling. The left upper eyelid was erythematous, swollen and had crusting along the lashes. There were mild inflammation and injection of the conjunctiva. The initial diagnosis was blepharitis, and it was recommended that he continue with the warm compresses, and doxycycline 100 mg to use if the symptoms worsened or did not improve. The patient underwent SARS-CoV-2 PCR testing as a requirement for travel the next day and was found to be positive for the virus. Over the following days, he developed fatigue and rhinitis but clinically improved within six days of his initial presentation. Physicians and health care workers should be aware of the ocular manifestations of SARS-CoV-2 to make a timely diagnosis of infected individuals. While requirements vary across institutions, it is highly recommended that healthcare workers consistently wear appropriate eye protection when interacting with patients to reduce the spread of disease and potential impact on ocular health from SARS-CoV-2. Additionally, to prevent ocular transmission, all healthcare workers should be immediately educated on the importance of eye protection.