Coronavirus (Covid-19) and your eyes

Background information

A new strain of Coronavirus, Covid-19, was reported from China in December 2019 and has rapidly become a global pandemic. Symptoms of COVID-19 include a mild to severe respiratory illness accompanied by a fever, cough and breathing problems, according to the World Health Organization (WHO).

Other symptoms include runny nose, sore throat and headache. Whilst most people will develop mild to moderate symptoms that don’t require hospital admission, the infection can be lethal in vulnerable individuals who may be older or have other health problems.

The infection is known to spread through contact transmission and hence many countries have imposed restrictions on individual movement, and recommendations for handwashing and protective masks. Simply put the infection spreads by touching a surface that has the virus and then touching one’s mouth, nose and possibly eyes. These parts of the face are covered by a type of tissue called mucous membrane which allows entry of the virus into the body and respiratory system. Transmission through direct inhalation is a possibility but requires close contact with an infected individual.

Healthcare workers caring for COVID – 19 patients are hence at increased risk infection by this route. Masks have been recommended primarily to stop the viral spread, but may also serve as a barrier to touching the nose and mouth before hand washing.

Does COVID-19 cause eye problems?

Covid-19 infection is an uncommon cause of conjunctivitis, which is self-limiting and indistinguishable from other types of common viral conjunctivitis. Common symptoms of conjunctivitis are a pink or red eye, mucous or clear discharge from the eyes, soreness, grittiness and itchiness. In the case of Covid-19, these symptoms may precede or occur together with all the other flu-like and respiratory symptoms of this infection. There have also been some reports of eye pain in COVID-19 infected patients. There is no evidence that COVID-19 infection damages the eyes yet.

Patients with viral forms of conjunctivitis should avoid touching their eyes of possible, wash their hands frequently, dispose of tissues that have been used to wipe the eye, avoid sharing towels or pillows with family members and avoid close facial contact with others. Symptomatic relief can be achieved with a regular cold compress over the eyes and using cooled lubricant eye drops such as Refresh or Theoloz Duo, which are over the counter medications.

If symptoms don’t improve, an eye doctor may prescribe a short course of steroid drops to calm surface eye inflammation. Antibiotics such as Chloramphenicol (Optrex infected eye drops) are ineffective against viral conjunctivitis but will treat the secondary bacterial infection which can occur from repeated eye touching with unclean hands. It is best to use a clean tissue to wipe the eye and dispose of this after every use, just as one would with a cold.

At this time of year people who suffer from seasonal allergies can also develop allergic conjunctivitis which may require anti-histamine and other drops.

Can a COVID 19 infection occur through the eyes?

At the present time, it is unclear whether COVID 19 can be acquired through the eyes. However, the mucous membrane covering of the eye is a potential entry point either through direct hand-eye contact or through droplet spread.

Peking University respiratory specialist Wang Guangfa contracted the illness after visiting the city of Wuhan and believes lack of eye protection may have been the cause, although the evidence for this is unclear. Viral RNA in tear samples taken from COVID 19 patients eyes have been low.

Glasses or contact lenses during the Covid-19 crisis

American Academy of Ophthalmologists has recommended that people should wear glasses rather than contact lenses during the current coronavirus pandemic. This is based on the theoretical risk of possible infection from touching the surface of the eye when putting in and removing contact lenses.

Contact lens wear can also be linked with bacterial infections and accessing hospital services in your local area with a bacterial contact lens-related ulcer may be difficult during this time of reduced NHS services. Lockdown may be the time to take a contact lens break.

What can you do to reduce the risk of getting COVID-19?

The new Coronavirus is spread through droplet and contact transmission. To cut your personal risk of contracting the new coronavirus follow these guidelines from the NHS:

• Wash your hands with soap and water often — do this for at least 20 seconds
• Always wash your hands when you get home or into work
• Use hand sanitiser gel if soap and water are not available
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
• Put used tissues in the bin immediately and wash your hands afterwards
• Avoid close contact with people who have symptoms of coronavirus

What is OCL doing to reduce the risk of COVID-19 transmission in the eye clinic/surgery environment?

As ever, the safety of our staff and patients is of paramount importance at OCL Vision.

Due to President Donald Trump’s now-infamous statements on the powers of detergents, you will be reassured that we continue to wipe down all surfaces in the clinic after each patient visit with medical-grade detergent wipes! We have implemented a number of widespread measures throughout the clinical and non-clinical environment at our clinic in Central London. 

As an elite clinic, the surgical theatre environment at OCL Vision utilises an ultra-clean unidirectional laminar airflow system. The Coronavirus correlates to particle sizes from 0.05µm-0.15µm and these particles – as well as many different sizes of potentially harmful particles – are captured by the ultra-clean air filtration system used by OCL.

We are the only surgical facility in London to offer this level of sterility in a Covid-19 free environment.

OCL has always used disposable instruments during surgery and hence there is no risk of cross-infection from one patient to another.