Note: This article reflects the latest published information about COVID-19 as related to eye care. As more information becomes available, I will update accordingly. (Last updated 4/7/2020)
The impact of the novel coronavirus disease is being felt all over the world. As our knowledge of the COVID-19 virus continues to evolve, it’s important to stay up-to-date with the most accurate information from reputable sources, so you can take the necessary steps to keep yourself and those around you safe from harm.
When it comes to your eye health, proper precautions need to be made to protect yourself from catching, or even potentially spreading, the COVID-19 virus. Here is what we know about the impact of coronavirus on the eyes, as well as ways you can keep your eyes healthy during the pandemic.
Coronavirus and Your Eyes
According to the World Health Organization (WHO), the coronavirus disease is an infectious disease caused by the COVID-19 virus. Symptoms such as fever, cough and shortness of breath can show up 2 to 14 days after a person is exposed. Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without special treatment. While the scientific community is still learning more about the COVID-19 virus, here is what we know so far about how it pertains to your eyes:
1. Coronavirus can enter the body through the eyes
When a sick person sneezes, coughs, or even talks, virus particles are exhaled from their mouth or nose. These droplets can land on nearby objects and surfaces, or be inhaled (via mouth or nose) by someone in close proximity. The COVID-19 virus may also enter the body through the superficial blood vessels within the conjunctiva of the eye and then spread to the whole body. This is why it is important to minimize how often you touch your face and eyes.
2. Coronavirus may cause a "pink eye"
There are several reasons why a person can develop a "pink eye" (conjunctivitis), such as allergies, bacteria, or viruses. Signs and symptoms of a viral conjunctivitis includes light sensitivity (photophobia), irritation, conjunctival injection, and watery discharge. Health officials have reported a viral conjunctivitis develops in about 1% to 3% of people with coronavirus.
3. There is a low risk of transmission of coronavirus through tears *(Updated)
A couple weeks ago, it was reported that ocular discharge and tears could be a potential source of contamination. This was according to findings in a Journal of Medical Virology study (dated 2/26/2020) that shows COVID-19 may be detected in tears and conjunctival secretions in novel coronavirus pneumonia patients with conjunctivitis. The danger here is that if a person infected with coronavirus AND conjunctivitis wipes their eyes and then touches another surface (or person's face) without washing their hands first, they could potentially spread the virus.
Since then, another study on this topic (dated 3/25/2020) was published in Ophthalmology. The researchers determined that coronavirus is known to be transmitted via droplets, but infected patients are unlikely to spread the virus through tears. There's one caveat: None of the patients in the study presented with conjunctivitis. One patient in the study did develop ocular symptoms (conjunctival injection and chemosis) during hospitalization, although "no evidence of SARS-CoV-2 could be found in the tear samples." Since the incidence of a viral conjunctivitis among infected patients is low (only 1-3%) to begin with, the research concludes that the risk of virus "transmission through tears regardless of the phase of infection is likely to be low."
4. Limiting eye exposure can help reduce one's risk of infection
Personal protective equipment (PPE) in the form of protective eyewear, such as full face respirators, face shields, safety glasses, or goggles, provides a barrier to infectious materials. All front-line healthcare workers should be equipped with a properly fitted N95 face mask and concurrent eye protection to protect against the COVID-19 virus.
At this time, there is no scientific evidence that eyeglasses or sunglasses provide proper protection against COVID-19 or other viral transmissions. While, glasses may prevent viral particles from spraying the eye directly, they won't protect the area above and below your eyes. Knowing that at least some of the virus can remain viable for hours to days on hard surfaces, such as plastic and stainless steel, there is still a risk of transmission by touching your glasses without wearing proper protection or following disinfection protocols. Try to limit how often you touch your glasses and be sure to clean your glasses on a regular basis.
Contact Lens Wear During COVID-19
Healthy individuals can continue to wear their contact lenses as prescribed by their optometrist. However, those who are infected with coronavirus or feel ill with cold or flu-like symptoms should stop wearing contact lenses. There are five things contact lenses wearers need to know about wearing and caring for their contact lenses during the COVID-19 pandemic.
Related Post: What Contact Lens Wearers Need to Know About Coronavirus
The Impact of COVID-19 on Eye Care
In accordance to a public health announcement issued by the Centers for Disease Control and Prevention (CDC), optometrists and ophthalmologists have been ordered to postpone all routine eye care visits, as well as elective and non-urgent procedures at this time. Many eye care practices have closed to abide by these guidelines, while other practices are remaining open for eye emergencies or urgent medical eye care only. If you are experiencing a true ocular emergency or you are suddenly without vision correction (in the form of glasses or contact lenses), call your local eye care provider to discuss how they may assist you.
How You Can Help to Stop the Spread
Follow these tips from the World Health Organization to keep yourself safe and help contain the spread of the virus.
Wash your hands with soap and water for 20 seconds.
Avoid touching your face, eyes, mouth, and nose.
Avoid contact with people who are vulnerable. And if you can’t, wear a mask.
Cover your cough with the bend of your elbow.
Disinfect surfaces you regularly use.
If you feel unwell, stay at home and call your healthcare provider.
Only share information from trusted sources.
Do you have any questions about COVID-19 and your eyes? Ask below!
Jianhua Xia, Jianping Tong, Mengyun Liu, Ye Shen, Dongyu Guo. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS‐CoV‐2 infection. Journal of Medical Virology, 2020; DOI: 10.1002/jmv.25725
Ivan Seah Yu Jun, Danielle E. Anderson, Adrian Eng Zheng Kang, Lin-Fa Wang, Pooja Rao, Barnaby Edward Young, David Chien Lye, Rupesh Agrawal. Assessing Viral Shedding and Infectivity of Tears in Coronavirus Disease 2019 (COVID-19) Patients. Ophthalmology, 2020; DOI: 10.1016/j.ophtha.2020.03.026