Ocular manifestations in patients with COVID-19

Abstract

Background: There are only few reports on ocular symptoms and manifestations in association with coronavirus disease 2019 (COVID-19). Objective: The aim of this study is to describe ocular manifestations in the anterior and posterior segments of the eye and to analyze viral prevalence in tears of patients with COVID-19. Methods: Hospitalized COVID-19 patients treated from 16 April 2020 to 7 January 2021 at this hospital were screened for ocular manifestations in the anterior and posterior segments. Conjunctival swabs were analyzed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA. Results: A total of 37 patients were enrolled in this study. In the anterior segment we found chemosis of the conjunctiva (5), hyposphagma (2) and conjunctivitis (1). In 11 patients vascular alterations and potentially disease-specific manifestations of the fundus were found in one or both eyes: retinal hemorrhages (5), cotton wool spots (5) and tortuosity (5). One patient demonstrated branch artery occlusion, one had branch retinal vein occlusion and two patients had positive conjunctival swab results in one or both eyes. Conclusion: Our findings of the anterior segment are commonly known, although not specific for COVID-19. Various vascular fundus abnormalities were found in the study; however, it is unclear whether these were correlated to systemic comorbidities or whether they were caused or exacerbated by COVID-19. This study suggests that the risk of viral transmission via tears is low.