Conjunctivitis, commonly known as pink eye, can be a symptom of COVID-19. This condition involves inflammation of the conjunctiva, the transparent membrane covering the white part of the eye and the inner surface of the eyelids. While often associated with various infections or allergies, its connection to the SARS-CoV-2 virus is recognized.
Conjunctivitis as a COVID-19 Symptom
Conjunctivitis is a recognized, though less common, symptom of COVID-19. Studies show it appears in a small percentage of cases, with prevalence rates varying. Among all eye-related symptoms, conjunctivitis is the most frequent, occurring in about 88.8% of patients with ocular issues related to COVID-19.
The virus may cause conjunctivitis by directly infecting the conjunctiva, as eye tissue contains ACE2 receptors that SARS-CoV-2 uses for cell entry. Alternatively, it could be an inflammatory response to the systemic infection. While some reports suggest conjunctivitis can be an initial or even sole symptom of COVID-19, it more frequently appears alongside other respiratory or systemic signs.
Identifying Pink Eye Symptoms
When conjunctivitis occurs, several distinct signs are observed. The affected eye or eyes typically appear red or pink due to engorged blood vessels. Individuals often experience a gritty sensation or a feeling that something is in their eye.
Watery discharge is common, though some may experience a thick, sometimes yellowish or whitish, discharge that can cause eyelids to stick together, especially upon waking. Other symptoms include burning or itching, swollen eyelids, and mild sensitivity to light. These manifestations can affect one eye initially and then spread to the other within a few days.
Differentiating from Other Causes
Distinguishing COVID-19-related conjunctivitis from other causes of pink eye, such as bacterial infections, allergic reactions, or other viral infections like adenovirus, relies on a combination of symptoms. Viral conjunctivitis, including that caused by SARS-CoV-2, often presents with watery discharge, whereas bacterial infections typically produce a thicker, pus-like discharge that can cause eyelids to stick together. Allergic conjunctivitis usually involves intense itching in both eyes, often accompanied by sneezing and a runny nose.
Accompanying systemic symptoms provide further clues. COVID-19-associated conjunctivitis may occur alongside fever, dry cough, shortness of breath, body aches, or a loss of taste or smell. Other viral conjunctivitis cases might be linked to common cold symptoms like a sore throat and runny nose, while bacterial conjunctivitis may not have systemic signs. A medical professional is necessary for a definitive diagnosis, especially given the symptom overlap.
Management and When to Seek Care
If pink eye is suspected, particularly with concurrent COVID-19 symptoms, several self-care measures can help manage discomfort and prevent spread. Applying warm or cool compresses to the closed eyelids can provide relief. Avoiding rubbing the eyes and maintaining good hand hygiene, including frequent hand washing, are important to prevent transmission. It is also advisable to use fresh towels and pillowcases daily and to avoid sharing personal items that touch the eyes.
Seek medical attention if symptoms worsen, or if there is severe eye pain, vision changes, or intense redness in one or both eyes. Immediate medical consultation is necessary if a newborn exhibits pink eye symptoms. If other COVID-19 symptoms are present, such as fever, cough, or difficulty breathing, contact a healthcare provider for testing and management.