Ocular manifestations of COVID-19 in the pediatric age group

Abstract

The coronavirus disease 2019 (COVID-19) is now known to be associated with several ocular manifestations. The literature thoroughly discussed those that affect adults, with a lesser focus in the pediatric age group. We aim to outline the various pediatric ocular manifestations described in the literature. The manifestations may be divided into isolated events attributed to COVID-19 or occurring in the new multisystem inflammatory syndrome in children (MIS-C), a novel entity associated by COVID-19 infection. Ocular manifestations have virtually affected all ages. They manifested in neonates, infants, children, and adolescents. Episcleritis, conjunctivitis, optic neuritis, cranial nerve palsies, retinal vein occlusion, retinal vasculitis, retinal changes, orbital myositis, orbital cellulitis were reported in the literature with this emerging viral illness. Conjunctivitis was the most common ocular manifestation in MIS-C in nearly half of the patients. Other ocular manifestations in MIS-C were anterior uveitis, corneal epitheliopathy, optic neuritis, idiopathic intracranial hypertension, and retinitis. The clinical outcome was favorable, and children regain their visual ability with minimal or no deficits in most of the cases. Further follow-up may be warranted to better understand the long-term effects and visual prognosis.

Post-COVID-19 Retinal Manifestations in Pediatric Patient with Retinoblastoma: A Case Report

“…Involvement of the posterior segment associated with COVID-19 infection is reported to be less common, and posterior uveitis related to COVID-19 infection is an infrequent presentation in both the adult and pediatric populations [9,21]. Upon reviewing the literature, our case stands out as the youngest patient presenting with retinal in ltrations and retinal vasculitis.…”

“…These changes include cotton-wool spots, retinal hemorrhages, microvasculopathy, paracentral middle acute maculopathy, central serous chorioretinopathy, papillophlebitis, optic neuritis, panuveitis, multifocal retinitis, necrotizing retinitis, retinal vascular occlusion, and Purtscher-like retinopathy. However, only a few studies addressed retinal ndings in the pediatric population [3,9]. Furthermore, a unique challenge arises within a speci c subgroup of children with retinoblastoma (RB) who contract COVID-19.…”

A prospective long-term evaluation of the ocular findings of children followed with the diagnosis of multisystem inflammatory syndrome (long-term evaluation of ocular findings following MIS-C)

“…Therefore, none of the cases needed topical treatment. The median Schirmer values were 18 mm (IQR: [15][16][17][18][19][20][21][22] in the right eye and 20 mm (IQR:15-25) in the left eye. The anterior segment findings of the other 21 patients (61.7%) were normal.…”

“…Although the rate was lower in our study, the most common finding in the first examination was conjunctivitis (17.6%). Conjunctivitis is the swelling and inflammation of the conjunctival tissue with the occlusion of the vessels [16]. It can cause epiphora, chemosis, pain, a reaction in tarsal follicles, and regional lymphadenopathy.…”

Peripheral nervous system involvement in SARS-CoV-2 infection: a review of the current pediatric literature

“…The association between optic neuritis and various viral infections is well known. Unilateral optic neuritis was described as an initial presentation of SARS-CoV-2 infection in a 10-year-old girl with vision loss in her left eye but without typical symptoms of COVID-19 ( 25 ). Another case presented with bilateral optic neuritis in neuromyelitis optica spectrum disorder (NMOSD), 10 days after a febrile illness highly suspected as SARS-CoV-2 infection (both parents were positive) ( 26 ).…”