The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has impacted global health. Beyond the lungs, the virus can affect other bodily systems. This influence extends to the eyes, where the infection can lead to ocular manifestations. Understanding these eye effects provides comprehensive information about the virus’s broader impact.
How COVID-19 Impacts the Eyes
The SARS-CoV-2 virus can affect the eyes through several biological mechanisms. One pathway involves direct viral infection of ocular tissues, as the virus utilizes angiotensin-converting enzyme 2 (ACE2) receptors found in cells on the eye’s surface, including the conjunctiva and cornea. While the density of these receptors in ocular tissues may be lower than in other parts of the body, their presence allows the virus to potentially enter, replicate, and spread locally within the eye.
Another way COVID-19 impacts the eyes is through the body’s inflammatory response to the infection. Severe COVID-19 can trigger a systemic inflammatory state, sometimes referred to as a “cytokine storm,” characterized by elevated levels of inflammatory molecules like IL-6 and TNF-α. This inflammation can lead to the infiltration of immune cells into eye tissues, potentially damaging epithelial structures and weakening the eye’s protective barriers.
Systemic inflammation can also induce microvascular changes throughout the body, including within the blood vessels of the eye. These changes may result in conditions such as retinal hemorrhages, “cotton wool” spots, or even blockages in retinal arteries and veins, which can impair blood flow and oxygen supply to the retina. Such ocular involvement can manifest during the acute phase of the illness or, in some cases, persist or emerge as a component of long COVID.
Common Ocular Symptoms
COVID-19 can present with eye symptoms, with conjunctivitis being frequently reported. This condition, often referred to as “pink eye,” involves inflammation of the conjunctiva, the clear membrane covering the white part of the eye and the inside of the eyelids. Symptoms include redness, itching, discharge, and watery eyes, and it can affect one or both eyes.
Individuals with COVID-19 may also experience photophobia, an increased sensitivity to light. This symptom can arise from inflammation or irritation caused by the virus, making even normal light levels uncomfortable or painful. Eye pain or soreness is another complaint, which can be linked to inflammation, dry eyes, or infection.
Blurred vision is also reported, though not always a direct viral symptom. Instead, it can result from other COVID-related eye issues such as dry eyes, inflammation of the cornea (keratitis), or inflammation within the eye (uveitis). These ocular symptoms can vary in severity and may appear alongside other COVID-19 symptoms like fever and cough, or as the primary symptom.
When to Seek Medical Attention
Seek medical help if you experience eye symptoms that are severe, persistent, or worsen over time, especially with a COVID-19 infection. Sudden vision changes, such as blurring, new floaters, or any degree of vision loss, warrant immediate consultation with an eye care professional. These could indicate more serious complications like retinal vascular occlusions, which are blockages in the eye’s blood vessels.
Severe eye pain, redness, or swelling that does not improve should also prompt a visit to a doctor. While many COVID-related eye symptoms, like conjunctivitis, are mild and resolve within a few days to two weeks, persistent issues require evaluation. If eye symptoms are accompanied by other severe COVID-19 symptoms, such as difficulty breathing or chest pain, it is important to seek emergency medical attention.
Consulting a healthcare provider ensures proper diagnosis and management, as eye symptoms can have various causes beyond COVID-19. They can perform an eye exam to determine the underlying issue and recommend appropriate treatment, which may include eye drops or other therapies. Self-treating should be avoided when symptoms are concerning, and guidance is recommended for eye health.