Although COVID-19 is a respiratory disease that commonly causes a sore throat, fever, shortness of breath, cough, and tiredness, you may not be aware of many other symptoms.
Conjunctivitis is the most common ocular condition associated with COVID-19.
Most COVID-related eye problems occur in people with severe infections.
Blurry vision or loss of vision warrants prompt medical attention since it can indicate more severe eye complications.
Good hygiene practices and general COVID precautions can help prevent eye complications.
Among these are COVID-related ocular problems that may appear similar to other eye conditions. It’s essential to consult your eye doctor to get an accurate diagnosis and treatment.
Eye conditions associated with COVID-19 infection
Studies estimate that 2% to 32% of COVID patients have ocular issues. Overall, eye symptoms are less present than those affecting the respiratory system. However, severe cases of COVID are twice as likely to present with eye symptoms than mild cases.
Some of the more common eye symptoms include:
- Light sensitivity
- Irritation or dryness
- Eye pain or soreness
- Burning sensation
Conjunctivitis is inflammation of the clear tissue overlying the whites of the eye (sclera) and the inner eyelids. It’s associated with redness, soreness, mucous discharge, tearing, irritation, and swelling of the eye and eyelids. The inner eyelids may show a follicular reaction, which appears as tiny bumps along with overall redness and inflammation of the tissue.
There is no specific treatment for COVID-19 conjunctivitis, and most cases improve over several days to a few weeks. Your eye doctor may recommend artificial tears or cool compresses to alleviate discomfort.
Episcleritis and scleritis
Episcleritis is inflammation of the connective tissue between the conjunctiva and sclera. Episcleritis may be sectoral (a section of the sclera that appears red) or diffuse (the entire white of the eye looks red). The eyes may also appear swollen with some discomfort.
Scleritis is more severe and affects the sclera, a deeper layer than the episclera. Scleritis causes intense pain, decreased vision, and a red-violet appearance to the eye. While episcleritis may resolve independently, scleritis requires treatment with steroids, nonsteroidal anti-inflammatory drugs, or immunosuppressive drugs.
Episcleritis and scleritis are often linked to systemic autoimmune and inflammatory disorders like rheumatoid arthritis and systemic lupus erythematosus. However, it has occasionally been linked to an infection. A few cases associated with COVID-19 disease have been reported. If the cause is infectious, you may receive antiviral or antibiotic medication.
Uveitis is inflammation of the middle layers of tissue in the eye (uvea). Anterior uveitis is the most common type and affects the colored iris. You may experience eye pain, light sensitivity, blurred vision, and redness when uveitis flares up.
This condition is associated with eye injuries, inflammatory diseases such as inflammatory bowel disease and Behcet’s disease, autoimmune diseases such as multiple sclerosis, and infection including COVID-19.
Uveitis is treated with steroid medication but can recur after it resolves. There is a report of one patient whose anterior uveitis remained inactive for 13 years but reactivated after recovering from COVID-19.
Central retinal vein occlusion (CRVO) and central retinal artery occlusion (CRAO)
CRVO occurs when the central vein carrying blood from the retina (light-sensitive tissue in the back of the eye) becomes blocked. Similarly, CRAO is a blockage of the main artery carrying blood to the retina.
Typically, older people with systemic conditions like diabetes, hypertension, or high cholesterol have a higher risk for CRAO and CRVO. However, both diseases have been found in healthy, young individuals who became infected with COVID-19. COVID causes an increased risk of blood clots in the body, which may lead to CRVO or CRAO.
The primary symptom of CRVO and CRAO is painless, blurred vision in one eye that occurs suddenly. Typically, CRAO causes more severe vision loss.
There is no specific treatment for CRVO, but you may receive eye injections if there are resulting complications in the retina. Your vision may improve over time. However, CRAO is considered an emergency and needs prompt medical attention to assess your risk for stroke or other complications. You may also receive medications, hyperbaric oxygen, or other therapies to restore blood flow to the eye before permanent vision loss occurs.
Optic neuritis is inflammation of the optic nerve, which transmits visual signals from the eye to the brain. Studies suggest neurologic symptoms occur in about a third of COVID-19 cases. Symptoms can include loss of smell, reduced sense of taste, dizziness, and headache to more severe disorders like Guillain-Barré syndrome and ischemic stroke.
The primary symptoms of optic neuritis are painful vision loss in one or both eyes. Some reports have noted optic neuritis in patients a few days to a few weeks after COVID-19 infection. Optic neuritis may improve independently but sometimes requires treatment with steroid medication.
As researchers continue to study SARS-CoV-2 variants, they may uncover other long-term ocular side effects of COVID-19 infection. So far, studies show that eye symptoms are significantly less common than respiratory symptoms.
However, the SARS-CoV-2 virus can be found in the eyes and tears. Experts believe the likelihood of contracting COVID-19 through the eyes is low, but more studies are needed. A good practice to reduce risk is to wash your hands thoroughly before and after touching your eyes. Masking, social distancing, and vaccination remain important in preventing the spread of COVID-19.