Ocular surface manifestation of COVID-19 and tear film analysis

Abstract

Purpose: To evaluate the ocular manifestation in patients hospitalized with coronavirus disease 2019 (COVID-19) and to search for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in tears.Methods: This study was conducted in 29 hospitalized patients who were admitted to the COVID center at the Policlinic Hospital of the University of Messina, Italy.All patients underwent an ophthalmologic assessment comprising a Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire, anterior segment, and the ocular surface examination of both eyes using a portable slit lamp.The Schirmer I test was performed, and the filter paper strip was used to search for the presence of SARS-CoV-2 on the ocular surface by real-time quantitative polymerase chain reaction (RT-qPCR).Results: A total of 10 patients reported ocular symptoms; in particular, four reported eye burning, three reported foreign body sensation, and three reported tearing. Moreover, seven patients presented conjunctival hyperemia and/or chemosis, eleven patients presented blepharitis signs such as lid margin hyperemia and/or telangiectasia, crusted eyelashes, and meibomian orifices alterations. Tear analysis did not reveal the presence of SARS-CoV-2.Conclusion: Ocular symptoms are common in patients with COVID-19; although, tear analysis did not reveal the presence of SARS-CoV-2.

The Ocular Manifestations of COVID-19 Through Conjunctivitis

“…Conjunctivitis appears to be the most prevalent ophthalmic manifestation of the disease and could potentially be one of the first symptoms of the virus. However, it has been demonstrated that patients infected with SARS-CoV-2 have presented with signs of blepharitis including lid margin hyperemia and/or telangiectasia, crusted eyelashes, and meibomian orifices alterations, potentially owing to the ability SARS-CoV-2 to alter the microenvironment and destabilize the tear film on the ocular surface epithelial cells and glands [ 11 ]. Without further research on the ocular symptoms related to SARS-CoV-2, it is possible that the virus could be overlooked in its early stages and the symptoms may be misidentified as more common causes of conjunctivitis (such as an allergic reaction or bacterial origin) rather than manifestations of the infection.…”