A Look at COVID-19 Ocular Symptoms

Article: COVID Can Cause Strange Eye and Ear Symptoms
Source: Scientific American
Published: November 17, 2021

Although loss of taste and smell are by now well-known symptoms of SARS-CoV-2 infection, ocular symptoms have been more perplexing. However, even from the onset of the COVID-19 pandemic, a connection between eyes and the SARS-CoV-2 virus had been noted, for example, in Chinese ophthalmologist Li Wenliang's observations among glaucoma patients. Scientific American  reported on a few recent studies. Almost two years into the pandemic, isolated reports of SARS-CoV-2 ocular signs and symptoms are still far from conclusive. However, systematic review data as of early 2021 estimated that 11% of people who contract COVID-19 develop ocular manifestations, including dry eye or foreign body sensation, redness, tearing, itching, eye pain, and discharge. Conjunctivitis was the most common diagnosis, affecting nearly 90% (79 of 89) of COVID-19 patients with ocular manifestations, suggesting broader consideration of symptoms in the detection of COVID-19. A study from April 2021 found a similar statistic: 9.5% (38 of 400) patients who were hospitalized for COVID-19 in Michigan had ocular manifestations; symptoms in these patients included "conjunctival injection, followed by vision changes and ocular irritation." In Italy, a study from March 2021 found SARS-CoV-2 on the ocular surface of 57% (52 of 91) of patients who were hospitalized for COVID-19. Although SARS-CoV-2 infection via ocular tissue was strongly implicated, but not proven, in some studies of hospital workers with and without mask-wearing, an intervention study in rhesus macaques found direct evidence that inoculating ocular conjunctiva with SARS-CoV-2 caused mild COVID-19 in these monkeys. Although most ocular symptoms resolve on their own, a minority of cases can result in permanent damage, for example, to corneal nerves, rendering susceptible to subsequent injury. Ultimately, the trigeminal nerve, and other facial nerves, provide a connection between the nasal passages, where a respiratory virus such as SAR-CoV-2 is most active, and the eyes. As such, the eyes can display early warning signs of infection, while at the same time being an organ that is susceptible to secondary damage.

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