COVID-19-related Conjunctivitis Review: Clinical Features and Management

ABSTRACT

Purpose

The ongoing coronavirus disease-2019 (COVID-19) pandemic has greatly impacted theworld. In this review article, we discuss the conjunctival and nasolacrimal mucosa as a potential route for the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) transmission, its ocular manifestations, and management.

Methods

Literature review was conducted in the PubMed, Google Scholar and EMBASE databases using keywords such as “coronavirus”, COVID-19”, “SARS-CoV-2”, “conjunctivitis”, “ocular surface”, “eye” and “ophthalmology”.

Results

The ocular surface may serve as an entry point and reservoir for the virus. Frequency of hand-eye contact was an independent risk factor for COVID-19-related conjunctivitis. Therefore, appropriate protective eyewear or face shields are recommended, especially for health-care workers. Bilateral conjunctival sampling within 9 days of symptom onset provides a higher positive yield rate. Pooled analysis shows an incidence of 11.4% (95%CI = 6.4–17.2%) of ocular manifestations in patients with SARS-CoV-2 infection, including hospitalized and non-hospitalized patients.

Conclusion

Conjunctivitis was the most common ocular manifestation, of which ocular redness or congestion, ocular pain, and follicular conjunctivitis were the most common presentation.COVID-19-related conjunctivitis has a self-limiting disease course, and treatment should be mainly supportive.

KEYWORDS:

• Conjunctivitis
• coronavirus
• COVID-19
• eye and ophthalmology
• keratitis
• ocular surface infection
• SARS-CoV-2

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Tufts Medical Center Institutional Support (PH), Boston, and Research to Prevent Blindness Challenge Grant to the Department of Ophthalmology, Massachusetts Lions Eye Research Fund, Inc (PH). The funding organizations had no role in the design or conduct of this research.