The global focus on COVID-19 initially centered on its respiratory effects, but research has confirmed that the virus can affect multiple organ systems, including the eyes. The eye surface is one of the body’s mucosal membranes, making it a potential site for viral entry and infection. Awareness of these non-respiratory symptoms is important for both diagnosis and preventing the spread of the virus.
The Direct Link: How COVID Affects the Eyes
The virus responsible for COVID-19, SARS-CoV-2, infects cells by binding to a specific protein on the cell surface called the Angiotensin-Converting Enzyme 2 (ACE2) receptor. Studies confirm that these ACE2 receptors are present on the human ocular surface, particularly on the epithelial cells of the conjunctiva. The conjunctiva is the thin membrane covering the white part of the eye and the inner surface of the eyelids. The presence of this receptor provides a direct pathway for the virus to infect the eye tissue.
When SARS-CoV-2 infects these cells, the most common resulting condition is viral conjunctivitis, often referred to as pink eye. The virus reaches the eyes through respiratory droplets or indirectly when a person touches a contaminated surface and then rubs their eyes. The eye becomes both a target for the virus and a potential source for transmission, as the virus can be found in tears and eye secretions.
Recognizing Ocular Symptoms Associated with COVID-19
The ocular symptoms linked to COVID-19 are varied, but they predominantly present as signs of conjunctivitis. A person may experience eye redness, which is a common indicator of inflammation on the eye’s surface. This is often accompanied by excessive tearing, or watering, as the eye attempts to flush out the irritant.
Patients frequently report a gritty feeling or foreign body sensation in the eye, along with general irritation or soreness. Discharge may also be present, which can be watery or sometimes sticky and mucoid. Light sensitivity, known as photophobia, is another reported symptom, indicating the inflammation is affecting the eye’s comfort level.
While these eye issues often appear alongside classic symptoms like fever and cough, they can occasionally be the first or only sign of a SARS-CoV-2 infection. Ocular manifestation has been reported in about 11% to 24% of cases. Recognizing these symptoms is important because it can prompt testing and isolation, even if respiratory symptoms are mild or absent.
Managing and Preventing Eye-Related Transmission
If eye symptoms occur, avoid touching or rubbing the eyes. This prevents worsening irritation and reduces the risk of spreading the virus to other surfaces or people. Strict hand hygiene is paramount, involving frequent washing with soap and water, especially before and after touching the face.
Individuals experiencing symptoms should temporarily switch from contact lenses to glasses. Glasses provide a physical barrier against respiratory droplets and reduce the temptation to touch the eye surface. Personal items that contact the eyes, such as towels, pillowcases, and eye drops, should not be shared.
Treatment for COVID-19-related conjunctivitis is typically supportive, focusing on managing discomfort, such as using cold compresses. Consult a healthcare provider immediately if symptoms are severe, include significant pain, or involve changes in vision. Following these hygiene protocols helps contain the virus, as tears and eye secretions can carry viral particles.