Pink Eye And Covid

Contents

Viral conjunctivitis is the most common cause of infectious conjunctivitis and is seen in people with a range of different viruses including the common cold, measles and the flu, so it’s not surprising that it would also be observed in patients with COVID-19. Infectious body fluids, including infectious respiratory droplets, can contaminate the conjunctiva of the eyes if an infectious person is coughing or sneezing around others.

Is pink eye (conjunctivitis) a sign of COVID-19?

Medically reviewed by Drugs.com. Last updated on March 21, 2022.

Official answer

by Drugs.com

Conjunctivitis, or pink eye, has been observed in a small number of patients diagnosed with COVID-19, the disease caused by the new coronavirus (SARS-CoV-2).

Conjunctivitis is inflammation of the thin membrane, called your conjunctiva, which covers the front of your eye and the back of your eyelids. Your conjunctiva helps to keep your eyes moist and lubricated, but when it becomes inflamed the small blood vessels in the area become more visible, causing the whites of your eye to appear a pink or red colour.

Viral conjunctivitis is the most common cause of infectious conjunctivitis and is seen in people with a range of different viruses including the common cold, measles and the flu, so it’s not surprising that it would also be observed in patients with COVID-19. Infectious body fluids, including infectious respiratory droplets, can contaminate the conjunctiva of the eyes if an infectious person is coughing or sneezing around others.

What was the first sign that conjunctivitis might be linked to SARS-CoV-2 infection?

One of the first indications that conjunctivitis might be a symptom of COVID-19 was back in January 22, 2020, when a member of China’s national expert panel on pneumonia, Guangfa Wang, reported he had developed COVID-19. Wang had been in contact with infected patients in Wuhan and while he had worn an N95 mask, he had not worn anything to protect his eyes. After becoming infected with the virus, Wang experienced symptoms of eye redness for several days before he developed pneumonia.

What does the research tell us about COVID-19-related conjunctivitis?

Researchers in China were only able to detect SARS-CoV-2 in the tear and conjunctival secretions from the one patient with conjunctivitis and COVID-19 in their 21-patient study. SARS-CoV-2, however, was not detected in the conjunctival sac in any of the other 20 COVID-19 patients who did not have conjunctivitis.

Another group of researchers working in Singapore, however, found no evidence of the virus in tear samples from the 17 patients with COVID-19 in their study. None of the 17 patients had eye symptoms when they were diagnosed, but one patient did develop red and swollen conjunctiva later on.

Data from a much larger group of 1099 COVID-19 patients in China, indicates that only 9 (0.8%) of the patients had symptoms of conjunctival congestion.

The above results indicate that conjunctivitis is not a common symptom of COVID-19 and there is a low risk of SARS-CoV-2 being spread through tears.

What should I do if I develop conjunctivitis?

It is important to remember that the common cold, a bacterial infection or allergies can cause conjunctivitis.

Bacterial conjunctivitis is more commonly associated with pus or discharge from the eye, compared with the watery discharge that may be seen with viral conjunctivitis. Antibiotic eye drops may be necessary to treat bacterial conjunctivitis.

Allergic conjunctivitis is triggered by allergens such as pollen or dust and is more likely to be associated with itchy eyes than viral conjunctivitis. Antihistamine eye drops can help to alleviate symptoms.

There is no treatment for viral conjunctivitis. It will usually clear up on its own after a short time. If you also develop a fever, dry cough and tiredness alongside your conjunctivitis, then it may be a sign that you have COVID-19.

Azari A, Barney NP. Conjunctivitis. A Systematic Review of Diagnosis and Treatment. JAMA. 2013 Oct 23; 310(16): 1721-1729. DOI: 10.1001/jama.2013.280318. Lu C-W, Liu X-F, Jia Z-F. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet. S0140-6736(20)30313 5. https://doi.org/10.1016/. Xia J, Tong J, Liu M, et al. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol. 2020 Feb 26. doi: 10.1002/jmv.25725.
Yu Jun IS, Anderson DE, Zheng Kang AE, Wang L-F, Rao P, Young BE, Lye DC, Agrawal R, Assessing Viral Shedding and Infectivity of Tears in Coronavirus Disease 2019 (COVID-19) Patients, Ophthalmology (2020), doi: https://doi.org/10.1016/j.ophtha.2020.03.026. Guan W, Ni z, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020. https://doi.org/10.1056/NEJMoa2002032. American Optometric Association. Conjunctivitis. Available online at: https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/conjunctivitis. [Accessed March 30, 2020].

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How Long Does Covid Pink Eye Last?

Viral conjunctivitis (pink eye) usually lasts about one to two weeks, however, if it occurs in conjunction with COVID-19, other symptoms may persist longer, depending on the severity of the infection.

COVID-19 (coronavirus disease 2019) is a novel (new) coronavirus responsible for an outbreak of respiratory illness that became a global pandemic in 2020. COVID-19 is different from other coronaviruses that cause mild illness, such as the common cold.
Pink eye (conjunctivitis) is an inflammation of the conjunctiva, the thin membrane that lines the inner surface of the eyelids and the whites of the eyes (called the sclera).
The virus that causes COVID-19 can cause pink eye in 1% to 3% of adults. The incidence may be higher in children.
Eye symptoms alone are probably not a sign of COVID-19, but if there is a known exposure to the virus or other symptoms of COVID-19 are present, such as a fever or cough, see a doctor to be tested for COVID-19.
Viral conjunctivitis usually lasts about one to two weeks, however, if you have COVID-19, other symptoms may persist longer, depending on the severity of the infection.

What Are Symptoms of Covid Pink Eye?

Symptoms of pink eye (conjunctivitis) caused by COVID-19 are the same as those from other viral causes, and may include:

Eye redness
Eye irritation and discharge
- May be watery or thick
- May be yellow, white, or green, and usually continues to drain throughout the day
- Affected eye often is crusty and stuck shut in the morning
- Irritation and discharge worsen for three to five days before improving, and symptoms can persist for two to three weeks
- Swollen lymph nodes (glands)
- Fever
- Sore throat
- Runny nose
Other symptoms of COVID-19 include:
- Shortness of breath
- Cough
- Fever or chills
- Muscle pain/body aches
- Changes in or loss of sense of taste and/or smell
- Headache
- Fatigue
- Sore throat
- Diarrhea
- Nausea
- Vomiting
- Loss of appetite
- Congestion
- Runny nose
- Abdominal pain
- Feeling unwell (malaise)
What Causes Covid Pink Eye?

COVID-19 pink eye is caused by a novel strain of coronavirus that is transmitted from person-to-person through respiratory droplets that are propelled into the air when an infected person sneezes or coughs.

Less commonly, COVID-19 may be transmitted when a person touches a surface or object that has the virus on it, and then touches their mouth, nose, or eyes.

Other causes of pink eye include:
- Viral infections
- Bacterial infections
- Allergies
- Toxic
- Nonspecific conditions
  - Dry eye
  - Irrigation after a chemical splash
  - Foreign body irritation (e.g., dust, eyelash)
  How Is Covid Pink Eye Diagnosed?
  
  COVID-19 (coronavirus disease 2019) is diagnosed with a medical history (including any recent known exposure to COVID-19) and physical exam, looking for symptoms of COVID-19.
  
  If COVID-19 is suspected, tests include:
  - PCR tests (genetic or molecular test)
  - Antigen test
  Pink eye is diagnosed with a physical examination of the eye. The diagnosis of pink eye is often made based on the presence of symptoms such as eye redness and discharge, and the patient’s vision is normal with no evidence of other eye conditions such as keratitis, iritis, or angle-closure glaucoma.
  
  Swabbing the eye for culture, stains, and direct antibody or polymerase chain reaction (PCR) testing is usually only used in uncommon or chronic cases that do not get better on their own or respond to treatment.
  
  IMAGES
  
  What Is the Treatment for Covid Pink Eye?
  
  Treatment for pink eye (conjunctivitis) caused by COVID-19 includes:
  - Topical antihistamine/decongestant eye drop to relieve eye irritation
    - Drops are available without a prescription in most pharmacies
    - Patients should be careful to avoid spreading the viral infection from one eye to the other
    - Drops should be applied to the affected eye only and hands should be washed thoroughly after application
    There is no current cure for COVID-19 (coronavirus disease 2019) and treatment is aimed at relieving symptoms in mild to moderate cases.
    
    Patients with mild to moderate illness are usually advised to remain home and self-isolate for up to 14 days to avoid spreading the virus. Treatments for mild to moderate COVID-19 symptoms include:
    - Over-the-counter (OTC) pain relievers
    - Cough suppressants
    - Rest
    - Drinking plenty of fluids
    For more severe COVID-19 cases, patients may require hospitalization. Treatments may include:
    - Monoclonal antibodies
    - Antiviral therapy with remdesivir
    - Corticosteroids
    - Immunotherapy
    - Antithrombotic therapy: anticoagulants and antiplatelet therapy
    - High-flow nasal cannula (HFNC) oxygen
    - Ventilation
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