The Ocular Manifestations and Transmission of COVID-19: Recommendations for Prevention

• Published in: The Journal of emergency medicine 2020-07, Vol.59 (1), p.137-140
• Main Authors: Dockery, Dominique M., Rowe, Susannah G., Murphy, Marjorie A., Krzystolik, Magdalena G.
• Format: Article
• Language: English
• Subjects: Betacoronavirus; conjunctivitis; Coronavirus; Coronavirus Infections; COVID-19; Humans; ocular transmission; ophthalmic precautions; Pandemics; Pneumonia, Viral - epidemiology; SARS-CoV-2; Tropism
• ISSN: 0736-4679; 2352-5029; 0736-4679
• DOI: 10.1016/j.jemermed.2020.04.060

Coronavirus disease-2019 (COVID-19), caused by a novel coronavirus termed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been linked to ocular signs and symptoms in several case reports. Research has demonstrated that SARS-CoV-2 is spread primarily through close contact via respiratory droplets, but there is the possibility for ocular transmission, with the conjunctiva as a conduit as well as a source of infection. Ocular manifestations of SARS-CoV-2 include follicular conjunctivitis, and have been repeatedly noted as an initial or subsequent symptom of COVID-19-positive patients. Particularly in patients with ocular manifestations, there is evidence that the virus may present in tears, based on the detection of SARS-CoV-2 in conjunctival swab samples via reverse transcription polymerase chain reaction. The virus may therefore be transmittable from the ocular surface to a new host via contact with the ocular mucosa, tears, or subsequent fomites. All health care professionals should ask patients about ocular symptoms consistent with SARS-CoV-2, and use eye protection such as goggles or face shields as part of the standard personal protective equipment for high-risk patients in addition to wearing of masks by both the patient and provider, and should consider tears to be potentially infectious.