While COVID-19, caused by the SARS-CoV-2 virus, primarily affects the respiratory system, the virus can also impact other parts of the body, including the eyes. This ocular involvement means eye symptoms might arise during or after a COVID-19 infection, making it an important area of study.
Ocular Manifestations of COVID-19
The SARS-CoV-2 virus can cause various eye problems, from mild irritation to more significant issues. The most common is conjunctivitis, or “pink eye,” which is inflammation of the conjunctiva, the transparent membrane covering the white part of the eye and the inside of the eyelids. Symptoms of COVID-19-related conjunctivitis include redness, itching, discharge, and a feeling of foreign matter in the eye. The discharge is typically watery, but can also be yellow or green.
Beyond conjunctivitis, other eye symptoms include epiphora (excessive tearing), photophobia (light sensitivity), eye pain, and blurry vision, often linked to inflammation or dry eye. More severe complications can involve the retina, such as retinal hemorrhages or “cotton wool” spots, which occur when blood clots impede nutrient flow. The virus’s ability to bind to ACE2 receptors, present in ocular tissues like the conjunctiva and cornea, may explain its direct effect on the eye.
Systemic inflammation triggered by the virus can also contribute to eye problems. This inflammation can lead to blood clots traveling to the eye’s blood vessels, potentially causing conditions like retinal artery occlusion or retinal vein occlusion, sometimes referred to as an “eye stroke.” While less frequent, these conditions can lead to vision changes or even vision loss.
Prevalence and Risk Factors for Eye Involvement
The occurrence of eye symptoms among individuals with COVID-19 varies across studies, but a notable percentage experience some form of ocular involvement. Approximately 1 in 10 people with COVID-19 develop an eye symptom, with prevalence ranging from 2% to 32%. Conjunctivitis is the most frequent eye condition reported.
Eye symptoms can occur at any stage of the disease, sometimes as initial signs. Rarely, conjunctivitis has been the only symptom of COVID-19. Risk factors for eye involvement include the severity of the illness, with a higher incidence in more severe cases. Individuals with pre-existing eye conditions, such as dry eye disease, may also be more prone to COVID-19-related eye complications. Additionally, underlying health conditions like diabetes, high blood pressure, and blood disorders can increase the risk of more serious eye complications, particularly those affecting the retina.
Guidance for Eye Symptoms During or After COVID-19
Experiencing eye symptoms during or after a COVID-19 infection can be concerning, but many mild cases resolve on their own. For mild symptoms like redness, itching, or irritation, self-care measures can provide relief. Applying cool or warm compresses to closed eyes for 10 to 15 minutes can help reduce discomfort and swelling. Maintaining good hand hygiene by washing hands frequently is important to prevent further irritation or spread. Avoid rubbing the eyes, as this can worsen symptoms and potentially introduce other infections.
Seek professional medical attention if eye symptoms are persistent, worsen, or are accompanied by more severe signs. Consult an ophthalmologist or primary care physician for severe eye pain, sudden changes in vision, or signs of infection like significant discharge or swelling. These symptoms could indicate a more serious underlying condition requiring specific treatment. An eye doctor can accurately diagnose the cause and recommend appropriate management, as similar eye problems can stem from various other causes.