The symptoms associated with COVID-19 have broadened over time, extending beyond the initial focus on respiratory issues. Red or irritated eyes, while frequently linked to common colds and seasonal allergies, can also be a manifestation of infection with SARS-CoV-2, the virus responsible for COVID-19. This ocular irritation is a recognized, though generally less common, part of the overall clinical picture. Understanding the connection and how to distinguish this symptom from other causes provides helpful context.
The Direct Connection: Red Eyes and COVID-19
Red eyes linked to COVID-19 are medically termed conjunctivitis, commonly known as pink eye. This is an inflammation of the thin membrane covering the white part of the eye and the inner surface of the eyelids. The SARS-CoV-2 virus can cause this inflammation by entering the body through the eye’s mucous membranes or by triggering a systemic inflammatory response. Viral particles found in tear samples indicate the eye surface can act as both a portal of entry and a reservoir for the virus.
Conjunctivitis typically presents as eye redness, increased tearing, and a sensation of grittiness or a foreign body in the eye. The virus utilizes specific receptors, like the angiotensin-converting enzyme 2 (ACE2) receptor, which are present on the ocular surface, allowing the virus to infect the tissue and cause irritation.
Prevalence Compared to Core Symptoms
Compared to hallmark symptoms like fever, cough, and fatigue, conjunctivitis occurs in a smaller percentage of individuals infected with SARS-CoV-2. Comprehensive analyses indicate ocular manifestations affect between 2% and 32% of patients in various studies. Conjunctivitis is the most common eye-related symptom, but it remains significantly less frequent than respiratory or systemic complaints.
This symptom can appear at any point during the illness, sometimes even preceding the onset of more typical respiratory symptoms. In rare instances, conjunctivitis may be the sole initial sign of infection, which can complicate early diagnosis. However, the probability of red eyes being the only symptom of COVID-19 is low compared to other common viral or allergic causes.
Distinguishing COVID-Related Eye Irritation from Other Causes
Differentiating COVID-related conjunctivitis from other common causes, such as bacterial infection or allergies, relies on recognizing specific accompanying signs. Conjunctivitis linked to SARS-CoV-2 is a form of viral pink eye, often characterized by a watery discharge and the simultaneous presence of systemic symptoms like fever, body aches, or a sore throat. It can affect one eye initially before spreading to the other.
In contrast, bacterial conjunctivitis is marked by a thick, sticky discharge that can cause the eyelids to stick together, especially upon waking. Allergic conjunctivitis, which is not contagious, typically involves intense itching, is often seasonal, and frequently co-occurs with other allergy symptoms such as sneezing and a runny nose. If red eyes are accompanied by a fever or difficulty breathing, a COVID-19 test is warranted to rule out infection. A healthcare provider’s evaluation is necessary to accurately determine the underlying cause of the eye irritation.
Managing Associated Eye Symptoms
Treatment for the viral conjunctivitis associated with COVID-19 focuses on supportive care, as the condition is typically self-limiting and resolves on its own within one to two weeks. Simple measures can help relieve discomfort, such as applying a cool compress to the closed eyelids to reduce inflammation and using artificial tears to lubricate the eye and alleviate the scratchy sensation. It is advisable to temporarily stop wearing contact lenses until symptoms have fully cleared.
Strict hygiene practices are important to prevent the spread of the virus, which can be transmitted through contact with eye secretions. This includes frequent and thorough handwashing, avoiding touching or rubbing the eyes, and regularly changing pillowcases and towels. Antibiotics are ineffective against viral conjunctivitis; they should only be used if a physician diagnoses a secondary bacterial co-infection.