COVID-19 is primarily understood as a respiratory illness, but the SARS-CoV-2 virus can affect multiple body systems. Ocular manifestations, or symptoms affecting the eyes, have been reported in some patients. This raises the question: can a coronavirus infection cause dry eyes? This article explores the connection between COVID-19 and dry eye syndrome, detailing its prevalence, biological mechanisms, and management steps.
Dry Eyes and COVID-19 Prevalence
Dry eyes are a recognized symptom of COVID-19, though they are not the most frequently reported ocular issue. Studies indicate that dry eye sensation or the feeling of a foreign body in the eye occurs in a significant minority of patients. For instance, a meta-analysis found that approximately 16% of COVID-19 patients who reported eye symptoms experienced dryness or a gritty sensation. Among survivors, a quarter of individuals evaluated months after infection presented with severe dry eye symptoms. When dry eye occurs, it typically manifests within two weeks of the onset of other systemic COVID-19 symptoms and usually resolves relatively quickly.
How COVID-19 Affects Ocular Health
The SARS-CoV-2 virus possesses the biological tools to directly affect the ocular surface. The virus initiates infection by binding to the Angiotensin-Converting Enzyme 2 (ACE2) receptor found on the surface of human cells. These ACE2 receptors are present in the epithelial cells of the conjunctiva, the clear membrane covering the white of the eye, and the cornea. The presence of these receptors suggests the eye is susceptible to viral entry and replication, which can trigger an inflammatory response. This localized inflammation compromises the stability of the tear film. The tear film, a three-layered coating that keeps the eye lubricated, breaks down when destabilized by inflammation, leading to excessive tear evaporation and the characteristic symptoms of dry eye.
Other Associated Eye Symptoms
Dry eye is often accompanied by other ocular symptoms of COVID-19. The most frequently reported issue is conjunctivitis, commonly known as pink eye, which involves inflammation of the conjunctiva. This condition typically presents with eye redness, excessive tearing, and sometimes a watery discharge. Other associated symptoms include photophobia, an uncomfortable sensitivity to light, and general eye pain. Distinguishing these symptoms is important: conjunctivitis involves visible redness and discharge, whereas dry eye is characterized by a gritty, burning, or foreign body sensation.
Symptom Management and Medical Guidance
Managing dry eyes focuses on alleviating discomfort and restoring the tear film. Over-the-counter artificial tear drops are the standard first-line treatment for lubrication; if drops are needed frequently, preservative-free formulations should be used to minimize irritation. Environmental adjustments can also provide relief, such as using a humidifier to increase air moisture and slow tear film evaporation. Since screen time reduces the natural blink rate, taking regular breaks and consciously blinking fully helps spread the tear film evenly. Furthermore, ensuring a face mask fits snugly over the nose prevents exhaled air from accelerating tear evaporation.
Seek professional medical guidance if symptoms worsen or new issues develop. Consult an eye doctor immediately if dry eye is accompanied by severe pain, sudden changes in vision, or significant blurring. If dryness persists long after other COVID-19 symptoms resolve, an ophthalmologist can determine the underlying cause and recommend prescription treatments.