COVID-19 had been by far the deadliest pandemic of present times. This is the only type of Coronavirus infection that has been known to present with eye findings such as conjunctivits as its first feature or later in the course of the disease as one of its many signs.
Since conjunctivitis known as red eye is quite commonly seen, it is important that we remember that in these times,COVID-19 can be one of its possible causes.
Should you see anyone in your immediate environment with symptoms of a red eye, you should alert them of the possibility of their being covid positive even if they have no other symptoms of Covid-19.
The sensible thing to do is to be cautious and limit close contact. Assume that any patient presenting to a clinic or otherwise with a red eye is to be suspected of having COVID conjunctivitis until a review of symptoms, a negative PCR or both can prove otherwise.
If you have been recently exposed to someone who has a red eye in these times, it would be advisable to ask them if they themselves had have had any recent travel, flu like illness, cough, fever and also if these symptoms have appeared in those with whom they may have been in close contact. Try and keep yourself and others safe and observe self isolation if necessary.
COVID-19 conjunctivitis often starts as a pinkish red appearance to the white of one eye. The fleshy part of the conjunctiva, on the inner side of the eyelid that faces the eyeball may be inflamed.
Patients with Covid conjunctivitis can have symptoms associated with red eye such as watering, foreign body sensation that feels like grittiness. In some cases conjunctivitis was the only sign of COVID-19 in a patient. In other patients the conjunctivitis appeared later in the disease process.
While the symptoms of Covid conjunctivitis may resolve on their own in the majority, in some the symptoms get worse with keratitis or inflammation of the cornea. Thin plaque like growths called psedomembranes can also be seen on the conjunctiva or fleshy part of the inner aspect of the eyelid. Inflammatory and viral deposits may also be seen on the cornea called pseduodendrites. Lymph nodes in front of and behind the ear can sometimes be swollen.
If a patient is suspected of having Covid 19 conjunctivitis they must be evaluated for definitive evidence of infection by way of PCR. Two consecutive negative PCR tests are required to consider a patient safe from a contagion point of view.
COVID conjunctivitis, like many other types of viral conjunctivitis often clears up on its own. The symptoms can be managed with cold compresses and lubricating drops. However, in a smaller number of patients severe conjunctivitis with involvement of the cornea may require treatment.
Following resolution of conjunctivitis, patients may experience and report signs and symptoms of mild to very severe dry eye which can cause superficial and deep ulceration in the cornea which left untreated can lead to irregular astigmatism which degrades vision, symblepharon formation which is formation of adhesions affecting the natural contour and smoothness of the conjunctivitis necessary for comfort. In some cases a secondary infection called a bacterial superinfection can take root due a weakened immune system in the presence of corneal surface abnormalities due to COVID conjunctivitis and corneal inflammation known as keratitis.
Hospitals and clinics should make every attempt to pre-screen such patients coming to outpatient areas and institute measures to isolate them from other patients. Equipment used to examine these patients should be disinfected before use with in clinical examinations for other patients.
At The Eye Center we offer both teleconsultations as well as in person evaluations. At our eye care facility, we have separate rooms in which we can isolate any patients who have suspected disease. This is important to keep all our patients safe. We adhere to strict SOP’s to keep our patients, their attendants and our staff safe at all time.
Should you or any one you know need to speak to one of our eight eye specialists virtually or in person, please call for an appointment at 03028291799, 03000822218, 021 35836713 or reach us through our appointment request online via our website www.surgicaleyecenter.org
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