Symptoms of Eyes in COVID-19

Incidence

Research fact:

One research has shown that 5 cases developed Conjunctivitis with COVID-19 positive but nobody had fever or any Respiratory complaints.

Pathology

Exact pathology not known but

Possible theories include direct inoculation of the ocular tissues from respiratory droplets or aerosolized viral particles, migration from the nasopharynx via the nasolacrimal duct, or even haematogenous spread through the lacrimal gland

Presentation

Conjunctivitis:

  • Unilateral/Bilateral
  • Painless conjunctivitis
  • Foreign body sensation
  • Burning eye
  • Redness of eye
  • Chemosis
  • Epiphora
  • Increased secretion
  • Conjunctival hyperaemia
  • Photophobia

O/E:

  • Mild follicular conjunctivitis, bulbar conjunctiva
  • palpebral conjunctiva,
  • watery discharge
  • mild eyelid oedema.
  • Bilateral Chemosis

Investigation

Conjunctival swab

(Tear- Viral RNA detected)

Type/ Feature Viral Conjunctivitis Bacterial Conjunctivitis
Onset and progression Involvement of one eye followed a few days later by other eye Involvement of other eye within 24-48 hours
Node Presence of enlarged pre-auricular node Not seen
Type Follicular conjunctivitis A papillary (Pseudo) membranous conjunctivitis
Discharge Watery discharge Mucopurulent or catarrhal discharge And conjunctival hyperaemia
It is often mild and goes way without treatment within 1-2 week, and if last for more than 2 week or more, complication developed
Major complication Punctate keratitis with sub epithelial infiltrates
Bacterial superinfection
Conjunctival scarring
Symblepharon
Sever dry eye
Irregular astigmatism
Corneal ulceration with persistent
Keratoconjunctivitis
Corneal scaring
Chronic infection