The Relationship Between COVID-19 and Conjunctivitis

3 min read  |  April 02, 2020  | 
Disponible en Español |

Our understanding of COVID-19 is evolving rapidly. One recent development is the ability of the virus to cause conjunctivitis in some patients. Here’s what you need to know.

To date, much of the medical focus on the COVID-19 outbreak has been on the flu-like fever and breathing problems that the illness can cause. Since it is these symptoms that can lead to severe illness and death in some patients, the attention is warranted.

Recently, however, another potential sign has emerged and could be useful in providing yet another indicator that COVID-19 might be present in a patient – viral conjunctivitis – an eye infection that is characterized by pink or red eyes that are often watery or have secretions

Thus far, the number of patients with both conjunctivitis and COVID-19 is relatively low.

“The reports show that between 1 and 3 percent of COVID-19 patients have conjunctivitis related to the disease,” says Florence Cabot, M.D., ophthalmologist at Bascom Palmer Eye Institute, part of the University of Miami Health System.

As with most of our data on COVID-19, however, this situation is still evolving. A recent study by the Journal of the American Medical Association, for example, noted that 2 of 38 patients at a particular health care facility in China had the virus in their upper respiratory tract (nasopharynx) and conjunctiva.

“We think that when the patient has the virus, infected droplets are reaching the eyes of a patient next to him or her and entering the body through the mucus membrane on the white part of the eye, the conjunctiva,” says Dr. Cabot.

In another, more extensive study published in the New England Journal of Medicine, nine of 1,099 confirmed COVID-19 patients from 30 hospitals across China presented “conjunctival congestion.”

How conjunctivitis can help in identifying COVID-19

Knowing that COVID-19 patients can develop conjunctivitis can help both individuals and health care providers, as it’s another way to identify potential cases of the virus. However, Dr. Cabot says that it’s important to keep in mind that conjunctivitis can have several other causes, as well.  Allergies, bacteria, or other viruses, such as the adenovirus, can all cause the condition and are more common. However, unlike COVID-19 related conjunctivitis, they are not typically associated with flu-like symptoms.

“If you have conjunctivitis right now, my recommendation is don’t rush to the emergency room,” she says. “Instead, stay home, wash your hands frequently (viral conjunctivitis are very contagious), don’t rub your eyes, use artificial tears, and call your eye doctor if symptoms are worsening. Telemedicine is a great opportunity for triaging patients to avoid unnecessary exposure to COVID-19. On a video call, your eye doctor can ask you further questions and get an overview of the situation to determine if you have conjunctivitis or a more serious eye problem that needs to be evaluated in the eye clinic or emergency room.”

When to see your doctor

Of course, when flu-like symptoms such as fever, shortness of breath, or coughing occur along with conjunctivitis, then Dr. Cabot says it’s time to reach out to your health care provider.

“My general rule with eye problems is to follow the RSVP precautions,” says Dr. Cabot. “If you experience severe redness, sensitivity to light, vision loss, or pain, then you should seek emergency medical care. Given the current exceptional circumstances, call your eye doctor first. Your eye doctor will tell you if you need to come into the eye clinic or emergency room.”

Wyatt Myers is a contributing writer for UMiami Health News.

Tags: COVID-19, infectious disease

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