Vol. 12 No. 3 (2020): Archives of Public Health
Review

COVID-19 and ophthalmic manifestations: review of the literature

Emilija Gjoshevska-Dashtevska
University Clinic for eye diseases; Medical Faculty, University Ss Ciril and Methodius, Skopje, Republic of Macedonia
Natasha Trpevska-Shekerinov
University Clinic for eye diseases; Medical Faculty, University Ss Ciril and Methodius, Skopje, Republic of Macedonia
Maja Ivanova
University Clinic for eye diseases; Medical Faculty, University Ss Ciril and Methodius, Skopje, Republic of Macedonia

Published 2020-12-15

Keywords

  • COVID-19,
  • ophthalmic manifestations,
  • conjunctivitis,
  • transmission,
  • prevention

How to Cite

1.
Gjoshevska-Dashtevska E, Trpevska-Shekerinov N, Ivanova M. COVID-19 and ophthalmic manifestations: review of the literature. Arch Pub Health [Internet]. 2020 Dec. 15 [cited 2021 Dec. 7];12(3):68-75. Available from: https://id-press.eu/aph/article/view/5636

Abstract

The epidemics of COVID-19 started in December 2019 in Wuhan, China, and the World Health Organization (WHO) officially declared a pandemic in March 2020. COVID-19 can also affect the eyes.  Ophthalmic manifestations of the virus are not so frequent; the prevalence is about 3% up to now. Recognizing the possibility of ophthalmic transmission and manifestation of the virus is of significant importance for ophthalmologists and health workers. According to published studies, the most common ophthalmic manifestation is follicular conjunctivitis with all the symptoms and signs of viral conjunctivitis.  It is usually bilateral, and patients present adenoviral-like symptoms, discomfort, foreign body sensation, redness, or they have no subjective symptoms. The symptoms are more pronounced in patients with a more severe clinical picture of the disease. One of the described non-specific manifestations of COVID-19 as an initial manifestation is keratoconjunctivitis. The effects of the virus on the retina and blood vessels have not been fully investigated, yet. It has been proven that COVID-19 can be isolated from tears and from ocular surface by PCR conjunctival swab. The most common mode of transmission is through direct contact and through aerosols. Through the nasolacrimal system, the eyes can be the entrance for respiratory infection and hematogenous spread of the virus can occur through the lacrimal gland. Early recognition of the ophthalmic symptoms by ophthalmologists as well as the other health workers during this pandemic is necessary because sometimes they can be the only manifestation of COVID-19, and on the other hand, it will lead to greater protection and prevention of the virus spreading. Prevention measures should be focused on the application of administrative protocols, personal protection and environmental control.

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References

1. World Health Organization. COVID-19 Situation Reports. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
2. Willcox MDP, Walsh K, Nichols JJ, Morgan PB, Jones LW. The ocular surface, coronaviruses and COVID-19. Clin Exp Optom 2020; 103: 418-424. doi:10.1111/cxo.13088
3. Mohan SV, Hemalatha M, Kopperi H, Ranjith I, Kumar AK. SARS-CoV-2 in environmental perspective: Occurrence, persistence, surveillance, inactivation and challenges. Chem Eng J 2021;405:126893. Published online 2020 Sep 4. doi:10.1016/j.cej.2020.126893
4. Ho D, Low R, Tong L, Gupta V, Veeraraghavan A, Agrawal R.COVID-19 and the Ocular Surface: A Review of Transmission and Manifestations. Ocular Immunology and Inflammation 2020; 28(5): 726-734. doi: 10.1080/09273948.2020.1772313
5. Hu K, Patel J, Patel BC. Ophthalmic Manifestations Of Coronavirus (COVID-19) [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK556093/
6. Olivia Li J-P, Chiu Lam DS, Chen Y, Wei Ting DS. Novel Coronavirus disease 2019 (COVID-19): The importance of recognising possible early ocular manifestation and using protective eyewear. Br J Ophthalmol 2020;104: 297-298.
7. Dockery DM, Rowe SG, Murphy MA, Krzystolik MG. The Ocular Manifestations and Transmission of COVID-19: Recommendations for Prevention. J Emerg Med 2020;59(1):137-140. doi: 10.1016/j.jemermed.2020.04.060
8. Hoenig LJ. The eye and COVID-19 pandemic. Clinics in dermatology 2020;38(4): 506. https://doi.org/10.1016/j.clindermatol.2020.03.013
10. AmestyMA, Alió del BarrioJL, Alió JL. COVID-19 disease and ophthalmology: An update. Ophthalmol Ther 2020; 9: 415- 426. https://doi.org/10.1007/s40123-020-00260-y
11. Ali MJ. The SARS-CoV-2, tears, and ocular surface debate: What we know and what we need to know. Indian J Ophthalmol 2020;68:1245-6.
12. Wu P, Duan F, Luo C, Liu Q, Qu X, Liang L, Wu K. Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China. JAMA Ophthalmol 2020;138(5):575–578. doi:10.1001/jamaophthalmol.2020.1291
13. Chen L, Liu M, Zhang Z, Qiao K, Huang T, Chen M, et al. Ocular manifestations of a hospitalized patient with confirmed 2019 novel coronavirus disease. Br J Ophthalmol 2020; 104:748–751. doi: 10.1136/bjophthalmol-2020-316304
14. Guan W-J , Ni Z-Y , Hu Y , Liang W-H, Ou C-Q , Jian-Xing He J-X , et al. Clinical characteristics of Coronavirus disease 2019 in China. N Engl J Med, 2020;382(18):1708-1720. doi: 10.1056/NEJMoa2002032
15. Hong N, Yu W, Xia J, ShenY, Yap M, Han W. Evaluation of ocular symptoms and tropism of SARS-CoV-2 in patients confirmed with COVID-19. Acta Ophthalmol 2020; 98: e649–e655. doi:10.1111/aos.14445
16. Salducci M, La Torre G. COVID-19 emergency in the cruise’s ship: a case report of conjunctivitis. Clin Ter 2020; 171(3): e189–91. doi:10.7417/CT.2020.2212
17. Gharebaghi R, Moshirfar M, Desuatels J, Parvizi M, Daryabari S-H, Heidary F, COVID-19: Preliminary Clinical Guidelines for Ophthalmology Practices. Med Hypothesis Discov Innov Ophthalmo 2019; 9(2): 149-158.
18. Güemes-VillahoN, Burgos‐Blasco B, Arribi-Vilela A, Arriola-Villalobos P, Rico-Luna CM, Cuiña‐Sardiña R, et al. Detecting SARS‐CoV‐2 RNA in conjunctival secretions: Is it a valuable diagnostic method of COVID‐19? J Med Virol 2020; 1– 6. https://doi.org/10.1002/jmv.26219
19. Seah IYJ, Anderson DE, Kang AEZ, Wang L, Rao P, Young BE, et al. Assessing viral shedding and infectivity of tears in coronavirus disease 2019 (COVID-19) patients. Ophthalmol 2020. doi: 10.1016/j.ophtha.2020.03.026
20. Lawrenson JG, Buckley RJ. COVID‐19 and the eye. Ophthalmic Physiol Opt 2020; 40: 383– 388. https://doi.org/10.1111/opo.12708
21. Olivares-de Emparan JP, Sardi-Correa C, López-Ulloa JA, Viteri-Soria J, Penniecook JA. Jimenez-Román J, Lansingh VC. COVID-19 and the eye: how much do we really know? A best evidence review. Arq Bras Oftalmol 2020; 83(3):250-61.