COVID-19 AND OPHTHALMIC MANIFESTATIONS: REVIEW OF THE LITERATURE
Journal
Archives of Public Health
Date Issued
2020
Author(s)
Maja Ivanova
Abstract
The epidemics of COVID-19 started in December 2019 in Wuhan, China, and the World Health Organization
(WHO) officially declared a pandemic in March 2020. COVID-19 can also affect the eyes. Ophthalmic
manifestations of the virus are not so frequent; the prevalence is about 3% up to now. Recognizing the
possibility of ophthalmic transmission and manifestation of the virus is of significant importance for
ophthalmologists and health workers. According to published studies, the most common ophthalmic
manifestation is follicular conjunctivitis with all the symptoms and signs of viral conjunctivitis. It is
usually bilateral, and patients present adenoviral-like symptoms, discomfort, foreign body sensation,
redness, or they have no subjective symptoms. The symptoms are more pronounced in patients with a
more severe clinical picture of the disease. One of the described non-specific manifestations of COVID-19
as an initial manifestation is keratoconjunctivitis. The effects of the virus on the retina and blood vessels
have not been fully investigated, yet. It has been proven that COVID-19 can be isolated from tears and
from ocular surface by PCR conjunctival swab. The most common mode of transmission is through
direct contact and through aerosols. Through the nasolacrimal system, the eyes can be the entrance for
respiratory infection and hematogenous spread of the virus can occur through the lacrimal gland. Early
recognition of the ophthalmic symptoms by ophthalmologists as well as the other health workers during
this pandemic is necessary because sometimes they can be the only manifestation of COVID-19, and
on the other hand, it will lead to greater protection and prevention of the virus spreading. Prevention
measures should be focused on the application of administrative protocols, personal protection and
environmental control.
(WHO) officially declared a pandemic in March 2020. COVID-19 can also affect the eyes. Ophthalmic
manifestations of the virus are not so frequent; the prevalence is about 3% up to now. Recognizing the
possibility of ophthalmic transmission and manifestation of the virus is of significant importance for
ophthalmologists and health workers. According to published studies, the most common ophthalmic
manifestation is follicular conjunctivitis with all the symptoms and signs of viral conjunctivitis. It is
usually bilateral, and patients present adenoviral-like symptoms, discomfort, foreign body sensation,
redness, or they have no subjective symptoms. The symptoms are more pronounced in patients with a
more severe clinical picture of the disease. One of the described non-specific manifestations of COVID-19
as an initial manifestation is keratoconjunctivitis. The effects of the virus on the retina and blood vessels
have not been fully investigated, yet. It has been proven that COVID-19 can be isolated from tears and
from ocular surface by PCR conjunctival swab. The most common mode of transmission is through
direct contact and through aerosols. Through the nasolacrimal system, the eyes can be the entrance for
respiratory infection and hematogenous spread of the virus can occur through the lacrimal gland. Early
recognition of the ophthalmic symptoms by ophthalmologists as well as the other health workers during
this pandemic is necessary because sometimes they can be the only manifestation of COVID-19, and
on the other hand, it will lead to greater protection and prevention of the virus spreading. Prevention
measures should be focused on the application of administrative protocols, personal protection and
environmental control.
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