Skip to main content

  • Editorial highlights first case of conjunctivitis as initial presentation for COVID-19

    Comprehensive Ophthalmology, Cornea/External Disease

    Add to My Bookmarks

    Review of: Novel Coronavirus disease 2019 (COVID-19): The importance of recognising possible early ocular manifestation and using protective eyewear

    Li J, Lam D, Chen Y, et al. British Journal of Ophthalmology, March 2020

    This editorial addressed the necessary protection for healthcare workers against COVID-19, and discussed the possibility of conjunctivitis being a presenting sign of the disease.

    Editorial summary

    At the time the editorial was published, more than 1,700 health care professionals had been infected with COVID-19. There had been 6 deaths among healthcare professionals, including 1 ophthalmologist. Of the affected healthcare workers, one was part of the expert task force who visited Wuhan, China. Despite being fully gowned with protective suit and N95 respirator, he was still infected by the virus; his first symptom was unilateral conjunctivitis, followed by development of fever a few hours later.

    Since this report, healthcare professionals in China have been urged to use eye protection when they are in close contact with patients. It is prudent to avoid touching the eyes, particularly for healthcare workers in the hospital environment. This may be particularly applicable where myopia is prevalent as many of the frontline healthcare workers will wear glasses or contact lenses and frequent touching of eyes or areas near the eyes will be habitual.

    Limitations

    The limitations of the manuscript are that it is an editorial written by 4 authors and presents a limited view of the experience with COVID-19.

    Clinical significance

    It is critical for all front-line health care providers to be aware that COVID-19 patients can present with conjunctivitis as the initial finding. It is important for the emergency physicians and eyecare professionals to inquire about travel history, systemic flulike symptoms and family history in such patients. The usual measures that apply to prevention of infection transmission, in particular thorough handwashing, should apply.

    Ophthalmologists should take particular care when examining patients because of proximity to the patients’ nose and mouth. In addition, they must wear appropriate eye protection, face protection and avoid touching any mucosal membranes. There is a need to stay highly vigilant to recognize early manifestations of COVID-19, including consideration of viral conjunctivitis as a possible presentation.