If the coronavirus is able to enter the body through the eye through its receptors on the conjunctiva, what visual problems can it cause?
There is a possibility of a person rubbing his or her eyes with hands already contaminated with infectious droplets and via the conjunctiva the infection can occur theoretically. This may cause a viral conjunctivitis with some redness and mild itching if at all.
There has been only Conjunctivitis reported so far from novel corona virus, although ACE2 receptor has also been found in internal structures of an eye, through which virus binds in conjunctiva.
Directly it does not causes any effect on vision, but is secondary to chemosis, watery eye.
Intense photophobia has also been reported and seen clinically.
This is supposition if we knew that other Coronavirus enter via the conjunctiva. Does anyone know if this is the case? We know that adenovirus has affinity as it can cause a keratoconjunctivitis.
Till date conjunctival findings are only manifestations but we suppose to have more of other manifestations. More of research activities on this can be done with high cautions.
In Nepal also till now, no other manifestations are reported I guess.
Apart from conjuntivitis, retinal findings in patients with COVID-19 have shown hyper-reflective lesions at the level of ganglion cell and inner plexiform layer, with subtle cotton wool spots and microhaemorrhages along the retinal arcade among few cases in a study conducted by Paula M Marinho and team, attributing this findings to CNS manifestation of COVID-19
A great question but still unknown. Xu et al. recently showed significant ACE-2 expression in the conjunctiva, and importantly also TMPRSS2 which aids intracellular SARS-CoV-2 viral transmission. This provides evidence of a pathway where SARS-CoV-2 could theoretically be transmitted via the conjunctiva.
To answer your question whether direct or indeed indirect innoculation of the virus results in any ocular manifestations is not understood. SARS-CoV-2 causes a hypercoaguable state in some patients with increased risk of thrombosis. The retinal changes describes could be solely attributable to this. The absence of evidence is certainly not proof, but it is reassuring that despite the world-wide incidence, reports of ocular manifestations are sparce and tenuous.
As we know most respiratory viruses cause ocular tropism, I'm surprised by the number of patients with conjunctivitis that I'm am not seeing in the clinic with SARS Co-V2. I have seen a few patients with CWS which I have no etiology.
Covid-19 ophtalmic manifestations and transmission path is still a controversial debate. Up to now, Sars-Cov2 has been identified (Rt-PCR) in conjunctival swabs of both symptomatic and asymptomatic patients with a positive oropharyngeal/ Nasopharyngeal Swabs.
However, some patients presented positive conjunctival swabs several prior to pharyngeal swabs, hypothesizing an ocular transmission.Moreover, some patients developped typical folicular conjunctivitis with negative ocular samplings, probably linked to an inflammatory response.
Some case reports have identified anterior scleritis as a possible manifestation of covid-19. Finally, only one paper, published on the Lancet, identified retinal manifestations such as hyper-reflective lesions in gabglion cell layer cotton wool-spots and microhaemorrage.
Conjunctivitiis is reported as early manifestation but retinal changes are also reported as mentioned by one respondent. There are conflicting reports of virus being cultured from tear film.
Hi everyone. Hope you are keeping safe. On the topic of the pandemic and ophthalmology, our research team just published an article on combined phacovitrectomy (as opposed to sequential vitrectomy and cataract surgery) and its advantages during the pandemic and thereafter.
Here's the link: Article Vitreoretinal Surgery in the Post-Lockdown Era: Making the C...
Recently I have seen a patient with Ant Uveitis with Covid. He tells me that in his locality there are several Covid positive patients with same eye problems.
Sen M, Honavar SG, Sharma N, Sachdev MS. COVID-19 and Eye: A Review of Ophthalmic Manifestations of COVID-19. Indian J Ophthalmol [serial online] 2021 [cited 2021 Feb 22];69:488-509. Available from: https://www.ijo.in/text.asp?2021/69/3/488/309403
DOI: 10.4103/ijo.IJO_297_21
This article comprehensively addresses the several ophthalmic manifestations due to COVID-19.