Ocular manifestations in SARS-CoV-2 positive patients: a systematic review

ABSTRACT

Objective: Investigate the importance of optical symptoms within SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) patients.Design: Systematic reviewMethods: Databases searched included Medline, EMBASE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Clinicaltrials.gov, ProQuest. As well, meeting abstracts from American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology and Canadian Ophthalmological Society were also considered. Articles underwent two rounds of screening before risk of bias assessment and data extraction.Results: In total, 582 studies were identified. A total of 2064 unique SARS-CoV-2 positive patients are included in this review from 13 different studies that met the inclusion criteria. We observed that the most common ocular symptoms in patients with SARS-CoV-2 were dry eyes, chemosis, epiphora, and blurred vision. The least common symptoms included hyperemia, conjunctivitis and photophobia. Additionally, we observed a unique relationship between patients with ocular manifestations and the severity of the systemic symptoms.Conclusion: Ocular symptoms do not occur commonly among SARS-CoV-2 positive patients; however, this study displays that there is an occurrence of common ocular manifestations such as dry eyes, chemosis, epiphora, and blurred vision. Therefore, increased ocular examinations may aid in diagnosis of SARS-CoV-2 infections.ABBREVIATIONS: COVID-19 (coronavirus disease 2019), SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2)

KEYWORDS:

• SARS-CoV-2
• ocular manifestation
• COVID-19
• ocular symptoms
• systematic review

Expert Opinion

In the authors’ opinion, the role of ocular symptoms in the clinical diagnosing of SARS-CoV-2 may be limited; however, ophthalmologists and other clinicans should consider the possbility of SARS-CoV-2 a part of their differential diagnosis in patients with ocular symptoms.

Author contributions

KV was involved in conception, design, analysis, interpretation of data, and writing and revising

RP was involved in analysis, interpretation of data, writing, and revising

SP was involved in writing

BY was involved in screening of articles

MM was involved in conception, design, revising article, and supervision

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was not funded.