COVID-19, primarily recognized as a respiratory illness, can also manifest with various eye-related symptoms and complications. While many associate the virus with fever, coughing, and breathing difficulties, its impact extends beyond the respiratory system. Eye involvement can range from commonly reported, mild irritations to less frequent, but potentially more serious, vision-threatening conditions. These ocular manifestations may emerge during the acute phase of the infection, often alongside other typical COVID-19 symptoms, or they can persist weeks to months after the initial viral clearance. Understanding these diverse effects on vision is important for individuals experiencing eye changes during or after a COVID-19 infection.
Common Eye Symptoms During Acute COVID-19
During the acute phase of a COVID-19 infection, many individuals may experience a range of eye symptoms. Conjunctivitis, commonly known as pink eye, is among the most frequently reported ocular manifestations, affecting an estimated 20% of people with COVID-19. This condition typically presents with redness, itching, and tearing of the eyes, sometimes accompanied by a watery or even yellow or green discharge. Individuals might also describe a burning sensation, soreness, or a feeling of grittiness, as if a foreign object is present in the eye.
Dry eyes are another prevalent symptom, contributing to discomfort and irritation. Some patients also report increased sensitivity to light, known as photophobia, which can make bright environments uncomfortable. These eye symptoms often emerge within the first week of a COVID-19 infection, frequently alongside more recognized respiratory or systemic signs.
In some instances, the virus may injure the nerves of the cornea, the clear outer layer of the eye, potentially leading to increased pain or blurred vision during the acute phase. While uncomfortable, these milder ocular issues are typically self-limiting, meaning they tend to resolve on their own within a few days to approximately two weeks as the acute infection subsides. In most cases, COVID-related conjunctivitis is mild and tends to resolve without specific medical intervention.
More Serious Ocular Complications
Beyond the more common irritations, COVID-19 can lead to less frequent but potentially more severe ocular complications, often arising from systemic effects of the virus. One significant concern involves retinal vascular events, where blood vessels in the retina, the light-sensing tissue at the back of the eye, are affected. This can include retinal artery occlusion, sometimes referred to as an “eye stroke,” where an artery blockage can lead to sudden blurry vision or even acute vision loss. Retinal vein occlusion, a blockage in a retinal vein, can cause blood and fluid to accumulate, resulting in blurred vision or, in severe cases, permanent blindness.
These vascular issues, along with the appearance of “cotton wool spots” — areas of retinal swelling due to nutrient deprivation from blocked capillaries — are often linked to the increased inflammation and blood clotting abnormalities that can occur with COVID-19. The virus’s systemic impact can heighten the risk of clot formation, which may then travel to the delicate blood vessels of the eye. Individuals with pre-existing conditions like diabetes or high blood pressure might face an elevated risk for these serious complications.
Another concerning complication is optic neuritis, which involves inflammation of the optic nerve, the pathway transmitting visual information from the eye to the brain. This condition can lead to pain with eye movement, blurred vision, and even significant vision loss. Direct viral effects or inflammation within the central nervous system can also result in neurological issues affecting vision, such as persistent blurry vision, double vision (diplopia), or specific visual field defects. While these serious eye problems are rare, they can develop in individuals regardless of the initial severity of their COVID-19 illness, typically manifesting anywhere from one to six weeks after symptom onset.
Persistent Vision Changes Post-COVID
For some individuals, eye-related symptoms of COVID-19 can extend far beyond the acute infection phase, becoming part of what is commonly referred to as “Long COVID.” These persistent vision changes can linger for weeks or months, even in those who experienced only mild initial symptoms. Common issues reported include chronic dry eyes, which can cause ongoing discomfort, irritation, and a gritty sensation. Persistent blurry vision is also frequently described, sometimes linked to the prolonged dry eye condition or general fatigue.
Eye fatigue and a continued sensitivity to light that does not resolve are other notable post-COVID visual complaints. Patients may also report ongoing eye pain, restricted vision, or a feeling as though something is constantly in their eye. These enduring symptoms can significantly impact daily activities, such as the ability to comfortably read or view screens for extended periods.
The exact mechanisms behind these long-term ocular issues are still under investigation. Researchers hypothesize that ongoing low-grade inflammation throughout the body, subtle microvascular damage to the eye’s tiny blood vessels, or lingering neurological dysfunction could contribute to these prolonged visual disturbances. While blurry vision itself may not always be a direct result of the virus, it can often arise from these secondary, persistent conditions or general post-viral fatigue.
When to Seek Medical Attention
While many COVID-19 related eye symptoms are mild and resolve on their own, it is important to know when to seek professional medical attention. Promptly consult an eye care professional or doctor if you experience sudden changes in your vision, such as new blurriness, partial or complete vision loss, or the appearance of blind spots or floaters. Persistent significant or severe eye pain, or a new onset of double vision, also warrants immediate evaluation.
Seek medical advice if your eye symptoms, even if initially mild, worsen over time or do not resolve within the typical one to two-week timeframe expected for acute symptoms. Individuals with pre-existing conditions like diabetes, high blood pressure, or blood disorders should be particularly vigilant, as these conditions can increase the risk of more serious ocular complications. An eye doctor can conduct a thorough examination, which might include imaging or specific tests, to identify signs of inflammation, vascular blockages, or nerve damage, ensuring appropriate management and preservation of vision.