COVID-19 Ocular Manifestation: A Cross-Sectional Study
Main Article Content
Keywords
COVID-19, Posterior subcapsular cataract, Follicular conjunctivitis, Central serous chorioretinopathy
Abstract
Introduction
The world is infected with a new strain of the coronavirus family known as COVID-19. This virus strain attacked several organs in the human body, causing symptoms ranging from mild to severe and, in some cases, life-threatening. Multiple organs, including the eye, can get infected.
Methods
The study was a single-center prospective cross-sectional study that included patients with a recent COVID-19 infection. The study was conducted in the ophthalmology department of Erbil Teaching Hospital in Erbil City from June 2021 to April 2022. The participants were recruited from the outpatient clinic in a non-probability convenience sampling way.
Results
The study included 75 patients. The most common ocular disease encountered in COVID-19 patients was posterior subcapsular cataract (12, 16.0%). Their ages are between 26 and 56 years old. The cataract developed in twelve patients (12, 16.0%), and it was bilateral in nine cases (18 eyes) with a varying degree of density. The next most common manifestation was multiple punctate epitheliopathy found in nine patients, which was bilateral in all of them. Follicular conjunctivitis was encountered in eight patients; it resolved in a period of 5 to 8 days after the prescription of topical anti-inflammatory medications.
Conclusion
COVID-19 infection is a multi-systemic disease that can cause a variety of ocular clinical symptoms and complications. Blurred vision and conjunctivitis-like features are the most common ocular presentations of the infection.
References
2. World Health Organization. Coronavirus disease (COVID-19). World Health Organization. 2020. Availablefrom: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19
3. CDC. COVID-19. Centers for Disease Control and Prevention. 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/index.html
4. Liu YC, Kuo RL, Shih SR. COVID-19: The first documented coronavirus pandemic in history. Biomedical Journal. 2020;43(4):328–33. doi:10.1016/j.bj.2020.04.007
5. Aso S. Muhialdeen, Jaafar Omer Ahmed, Hiwa O. Baba, Ismael Y. Abdullah, Hemn Ali Hassan, Kayhan A. Najar, et al. Kscien’s List; A New Strategy to Discourage Predatory Journals and Publishers (Second Version). Barw Medical Journal. 2023;1(1) doi:10.58742/bmj.v1i1.14
6. Yesudhas D, Srivastava A, Gromiha MM. COVID-19 outbreak: history, mechanism, transmission, structural studies and therapeutics. Infection. 2020;49(2). doi:10.1007/s15010-020-01516-2
7. Sharma A, Ahmad Farouk I, Lal SK. COVID-19: A Review on the Novel Coronavirus Disease Evolution, Transmission, Detection, Control and Prevention. Viruses. 2021 Jan 29;13(2):202. doi:10.3390/v13020202
8. Qing H, Li Z, Yang Z, Shi M, Huang Z, Song J, et al. The possibility of COVID‐19 transmission from eye to nose. Acta Ophthalmologica. 2020;98(3). doi:10.1111/aos.14412
9. Hu K, Patel J, Patel BC. Ophthalmic Manifestations of Coronavirus (COVID-19). PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556093/
10. Willcox MD, Walsh K, Nichols JJ, Morgan PB, Jones LW. The ocular surface, coronaviruses and COVID‐19. Clinical and Experimental Optometry. 2020;103(4):418–24. doi:10.1111/cxo.13088
11. Perlman A, Vodonos Zilberg A, Bak P, Dreyfuss M, Leventer-Roberts M, Vurembrand Y, et al. Characteristics and Symptoms of App Users Seeking COVID-19–Related Digital Health Information and Remote Services: Retrospective Cohort Study. Journal of Medical Internet Research. 2020;22(10): e23197. doi:10.2196/23197
12. Güemes-Villahoz N, Burgos-Blasco B, García-Feijoó J, Sáenz-Francés F, Arriola-Villalobos P, Martinez-de-la-Casa JM, et al. Conjunctivitis in COVID-19 patients: frequency and clinical presentation. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2020;258(11):2501-7. doi:10.1007/s00417-020-04916-0
13. Rokohl AC, Loreck N, Wawer Matos PA, Zwingelberg S, Augustin M, Dewald F, et al. More than loss of taste and smell: burning watering eyes in coronavirus disease 2019. Clinical Microbiology and Infection. 2020;26(11): 1560.e5–8. doi:10.1016/j.cmi.2020.08.018
14. Abrishami M, Tohidinezhad F, Daneshvar R, Omidtabrizi A, Amini M, Sedaghat A, et al. Ocular Manifestations of Hospitalized Patients with COVID-19 in Northeast of Iran. Ocular Immunology and Inflammation. 2020;28(5):739–44. doi:10.1080/09273948.2020.1773868
15. Oxidative stress: how to fight it naturally [Internet]. www.supersmart.com. [cited 2023 Oct 27]. Available from: https://www.supersmart.com/en/blog/anti-ageing/oxidative-stress-symptoms-causes-protection-s607
16. D’Amico Ricci G, Del Turco C, Belcastro E, Palisi M, Romano MR, Pinna A, et al. Covid-19 and acute conjunctivitis: Controversial data from a tertiary refferral Italian center. European Journal of Ophthalmology. 2021;31(6):2910–3. doi:10.1177/1120672121991049
17. Navel V, Chiambaretta F, Dutheil F. Haemorrhagic conjunctivitis with pseudomembranous related to SARS-CoV-2. American Journal of Ophthalmology Case Reports. 2020; 19:100735. doi:10.1016/j.ajoc.2020.100735
18. Bostanci Ceran B, Ozates S. Ocular manifestations of coronavirus disease 2019. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2020;258(9):1959–63. doi:10.1007/s00417-020-04777-7
19. Öncül H, Öncül FY, Alakus MF, Çağlayan M, Dag U. Ocular findings in patients with coronavirus disease 2019 (COVID‐19) in an outbreak hospital. Journal of Medical Virology. 2020 ;93(2):1126–32. doi:10.1002/jmv.26412
20. Walinjkar JA, Makhija SC, Sharma HR, Morekar SR, Natarajan S. Central retinal vein occlusion with COVID-19 infection as the presumptive etiology. Indian Journal of Ophthalmology [Internet]. 2020;68(11):2572–4. doi:10.4103/ijo.IJO_2575_20
21. Sheth J, Narayanan R, Goyal J, Goyal V. Retinal vein occlusion in COVID-19: A novel entity. Indian Journal of Ophthalmology. 2020;68(10):2291. doi:10.4103/ijo.IJO_2380_20
22. Invernizzi A, Pellegrini M, Messenio D, Cereda M, Olivieri P, Brambilla AM, et al. Impending Central Retinal Vein Occlusion in a Patient with Coronavirus Disease 2019 (COVID-19). Ocular Immunology and Inflammation. 2020;28(8):1290–2. doi:10.1080/09273948.2020.1807023
23. Gaba WH, Ahmed D, Nuaimi RKA, Dhahani AAA, Eatmadi H. Bilateral Central Retinal Vein Occlusion in a 40-Year-Old Man with Severe Coronavirus Disease 2019 (COVID-19) Pneumonia. The American Journal of Case Reports [Internet]. 2020;21: e927691-1e927691-5. doi:10.12659/AJCR.927691
24. Honavar S, Sen M, Sharma N, Sachdev M. COVID-19 and Eye: A Review of Ophthalmic Manifestations of COVID-19. Indian Journal of Ophthalmology. 2021;69(3):488. doi:10.4103/ijo.IJO_297_21
25. Collange O, Tacquard C, Delabranche X, Leonard-Lorant I, Ohana M, Onea M, et al. Coronavirus Disease 2019: Associated Multiple Organ Damage. Open Forum Infectious Diseases. 2020;7(7). doi:10.1093/ofid/ofaa249
26. Mazzotta C, Giancipoli E. Anterior Acute Uveitis Report in a SARS-CoV-2 Patient Managed with Adjunctive Topical Antiseptic Prophylaxis Preventing 2019-nCoV Spread Through the Ocular Surface Route. International Medical Case Reports Journal. 2020; 13:513–20. doi:10.2147/IMCRJ.S260252
27. Providência J, Fonseca C, Henriques F, Proença R. Serpiginous choroiditis presenting after SARS-CoV-2 infection: A new immunological trigger? European Journal of Ophthalmology. 2020;112067212097781. doi:10.1177/1120672120977817
28. Dinkin M, Gao V, Kahan J, Bobker S, Simonetto M, Wechsler P, et al. COVID-19 presenting with ophthalmoparesis from cranial nerve palsy. Neurology. 2020 doi:10.1212/WNL.0000000000009700
29. Falcone MM, Rong AJ, Salazar H, Redick DW, Falcone S, Cavuoto KM. Acute abducens nerve palsy in a patient with the novel coronavirus disease (COVID-19). Journal of American Association for Pediatric Ophthalmology and Strabismus. 2020;24(4):216–7. doi:10.1016/j.jaapos.2020.06.001
30. Pascual-Goñi E, Fortea J, Martínez-Domeño A, Rabella N, Tecame M, Gómez-Oliva C, et al. COVID-19-associated ophthalmoparesis and hypothalamic involvement. Neurology - Neuroimmunology Neuroinflammation. 2020;7(5): e823. doi:10.1212/NXI.0000000000000823
31. Belghmaidi S, Nassih H, Boutgayout S, El Fakiri K, El Qadiry R, Hajji I, et al. Third Cranial Nerve Palsy Presenting with Unilateral Diplopia and Strabismus in a 24-Year-Old Woman with COVID-19. American Journal of Case Reports. 2020;21. doi:10.12659/AJCR.925897
32. Zhou S, Jones-Lopez EC, Soneji DJ, Azevedo CJ, Patel VR. Myelin Oligodendrocyte Glycoprotein Antibody–Associated Optic Neuritis and Myelitis in COVID-19. Journal of Neuro-Ophthalmology. 2020;40(3):398–402. doi:10.1097%2FWNO.0000000000001049
33. Szczęśniak M, Brydak-Godowska J. SARS-CoV-2 and the Eyes: A Review of the Literature on Transmission, Detection, and Ocular Manifestations. Medical Science Monitor. 2021;27. doi:10.12659%2FMSM.931863
34. Turbin RE, Wawrzusin PJ, Sakla NM, Traba CM, Wong KG, Mirani N, et al. Orbital cellulitis, sinusitis and intracranial abnormalities in two adolescents with COVID-19. Orbit. 2020;39(4):305–10. doi:10.1080/01676830.2020.1768560
35. Shires CB, Klug T, Dryden S, Ford J. Unusual cause of acute sinusitis and orbital abscess in COVID-19 positive patient: Case report. International Journal of Surgery Case Reports. 2021; 79:164–8. doi:10.1016/j.ijscr.2021.01.043
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