Since the start of the Covid-19 pandemic, many people have reported a wide variety of symptoms beyond the typical fever, cough, and shortness of breath. One of the more curious symptoms that some patients have experienced is eye pain or irritation. In this article, we’ll explore whether Covid-19 can in fact cause eye symptoms, the possible mechanisms behind it, and what you should do if your eyes hurt after contracting the coronavirus.
Can Covid-19 affect your eyes?
The answer seems to be yes, Covid-19 can sometimes cause eye issues like pain, dryness, irritation, and redness. Here’s a quick overview of some of the evidence:
– Multiple studies have found that up to 1/3 of Covid-19 patients report eye symptoms. In one study of nearly 1,100 hospitalized patients, 32% experienced an eye complaint.
– The most common eye-related symptoms are conjunctivitis (pink eye, affecting 11.2% of patients), eye pain, increased tearing, and dry eye.
– SARS-CoV-2, the virus that causes Covid-19, has been detected in eye secretions in some patients with Covid.
– Doctors are seeing more cases of conditions like “coronavirus keratoconjunctivitis” – a type of viral pink eye – in Covid-19 patients.
So in summary, while not all Covid-19 patients experience eye issues, it’s clear the virus can affect the eyes in some people. Ocular symptoms tend to be mild compared to more serious lung and cardiovascular effects, but are still reported in about 1 in 3 hospitalized patients.
How does the coronavirus affect the eyes?
There are a few hypothesized ways Covid-19 could directly or indirectly lead to eye discomfort and other symptoms:
– The eyes are a direct viral target. SARS-CoV-2 may directly infect the conjunctiva, cornea, and other ocular tissues just like other viruses can cause pink eye. The virus could spread from the respiratory tract to the eyes in droplets or via the nasolacrimal duct that connects the nose and eyes.
– Inflammation triggered by the viral infection may spread systemically or indirectly cause eye inflammation. The immune response and cytokine release against the virus may manifest in dry eyes or other ocular changes.
– Eye aggravation could result from medication side effects, stress, reduced blink rate from fever/illness, or other indirect factors. Hospital treatments like prone positioning of ventilated patients may also dry the eyes.
– Individuals prone to dry eye disease or recurrent viral conjunctivitis may experience more eye discomfort if they get Covid due to exacerbation of their underlying condition.
So in summary, the virus may directly attack the eyes, but likely also causes eye discomfort secondarily from inflammation, medications, stress, and other factors. More research is still needed to further understand the mechanisms.
What eye symptoms are most common with Covid-19?
Here is an overview of some of the most frequently reported eye-related symptoms in patients with Covid-19:
| Conjunctivitis (pink eye) | 11.2% |
| General eye pain or soreness | 10.3% |
| Excess tearing (epiphora) | 5.2% |
| Dry eyes | 4.8% |
| Itching eyes (pruritis) | 4.1% |
| Photophobia (light sensitivity) | 2.4% |
| Redness (injection) | 2.2% |
Pink eye is the most common and well-documented eye complaint. However, general irritation and pain in and around the eyes is also frequently reported. The virus may also cause excess tear production and dry eye in some patients.
In most cases, Covid-related eye symptoms seem to be transient and resolve after recovery from the acute infection. But a small percentage of patients are left with longer lasting eye discomfort and dryness.
When do eye symptoms start with Covid?
Timing of eye symptoms seems to vary between patients. Here’s an overview:
– Conjunctivitis often occurs early and may be one of the first symptoms noticed in some patients.
– In one study, about 66% of patients developed conjunctivitis within just the first 2 days after the onset of systemic Covid symptoms like fever and cough.
– However, other eye complaints like pain, irritation, photophobia, and vision changes more often start after systemic symptoms are already present.
– Late onset eye problems days to weeks after acute Covid recovery have also been reported, likely due to residual inflammation or dryness.
So in mild cases, pink eye or irritation may arise early on along with initial respiratory symptoms. But in severe cases requiring hospitalization, eye issues tend to pop up after systemic manifestations when viral load and inflammation are peaking. While timing varies, eye symptoms rarely seem to occur in isolation without other Covid manifestations.
How long do eye symptoms last with Covid?
The duration of Covid-related eye symptoms depends on the specific manifestation and severity. Here’s an overview:
– Viral conjunctivitis often resolves within 2-3 weeks, similar to timing with other common viral pink eye causes.
– Mild eye pain, irritation, and inflammation tends to be transient and clear within a week or two as systemic infection improves.
– More severe cases resulting in corneal abrasion, uveitis, or other eye complications may take several weeks to fully resolve.
– Post-viral dry eye can linger for months after initial recovery and may cause chronic irritation.
So like other Covid manifestations, mild eye symptoms usually resolve quickly within a couple weeks max as the immune system clears the infection. But some patients are left with longer term dryness or other residual issues requiring topical lubricants or ophthalmic care.
Can Covid cause permanent eye damage or vision loss?
Permanent vision damage from Covid is possible but considered very rare. Here’s an overview:
– Cases of neuro-ophthalmic conditions like optic neuritis (nerve inflammation) and vision loss have been reported after Covid, but are extremely rare. These likely stem from severe systemic inflammation/hypoxia affecting the optic nerves or brain rather than direct viral damage.
– Corneal abrasions, ulcers, and other injuries are possible but typically heal without permanent damage if properly managed.
– Preexisting conditions like glaucoma or macular degeneration may worsen temporarily from systemic infection and inflammation. But Covid is not known to cause these conditions directly.
– While urgent eye complications can occur, no solid link has been found between Covid-19 and conditions causing permanent blindness like cataracts, retinal detachment, or optic nerve atrophy.
So in summary, while Covid can certainly cause eye discomfort and temporary vision changes from things like dryness and light sensitivity, there is no evidence it directly damages the eyes or optic nerves leading to lasting vision loss or blindness. Still, severe Covid cases do carry risks of neuro-ophthalmic issues that require prompt attention.
When to seek emergency eye care with Covid?
Most Covid-related eye symptoms are mild and self-limiting. But some severe manifestations require urgent ophthalmology care. Seek immediate help if you experience:
– Sudden loss of vision or severe vision changes in one or both eyes
– Intense eye pain not relieved by OTC medication
– Nausea/vomiting suggesting very high eye pressure
– Redness with eyelid swelling and discharge suggesting bacterial infection
– Colored halos around lights, suggesting uveitis
– Pupils that are uneven in size or have sluggish response to light
– Foreign body sensation or eyelid drooping suggesting corneal scratch or nerve/muscle issue
While most Covid eye issues resolve on their own, immediate medical care is crucial if you notice any of these more alarming vision symptoms that could reflect deeper injury or neurological issues. Don’t hesitate to go to the ER or call your eye doctor if you have sudden, severe changes in vision.
Can I spread Covid through my eyes?
It’s theoretically possible to spread Covid through the eyes, but this route is considered far less contagious than respiratory droplet transmission. Here are a few key points:
– SARS-CoV-2 has been detected in the conjunctival fluid and tears of some infected patients. So eyes may harbor small amounts of virus.
– Rubbing eyes with contaminated hands could potentially spread infection. But hand hygiene minimizes this risk.
– Respiratory droplets from an infected person’s cough or sneeze directly reaching another person’s eyes is unlikely unless in very close contact.
– Airborne transmission via tiny aerosolized droplets is more relevant to inhaled virus versus ocular surface exposure.
So while viral shedding in eye secretions provides a theoretical possibility, poor hand hygiene would be needed to directly contaminate the eyes. Overall the eyes are a less hospitable transmission environment than the warm moist respiratory tract. But it’s smart to avoid touching the face and practice good hygiene with or without Covid as a general precaution.
Home remedies and treatments for Covid eye symptoms
For mild cases, there are some self-care steps you can take at home to manage eye discomfort related to Covid:
– Use lubricating drops like artificial tears to soothe dryness and irritation. Preservative-free drops are ideal if symptoms persist.
– Take breaks from screens, use warm compresses, sleep with a humidifier to ease eye strain and dryness.
– Wear sunglasses outdoors and avoid irritants like cigarette smoke that can worsen discomfort.
– OTC antihistamine eye drops can provide relief from allergic-type symptoms of itching, redness, and watering eyes.
– Tylenol, ibuprofen, cold compresses can help reduce eye pain and inflammation.
– Drink lots of fluid and eat vitamin A & C-rich fruits/veggies to promote healing.
– Follow your eye doctor’s advice if you use prescription eye medications for glaucoma, allergies etc.
Severe symptoms like significantly reduced vision, intense pain, sensitivity to light, or sudden onset of floaters/flashes warrant an urgent eye exam and possible medication, especially if you have high Covid fever. But in mild cases, conservative symptom relief and lubrication of the eyes is often sufficient as viral eye symptoms run their course.
Preventing Covid eye symptoms
While no proven treatment exists to prevent Covid eye involvement, some logical precautions include:
– Practicing hand hygiene and avoiding face touching to lower viral transmission to eyes.
– Taking prescribed antivirals if available and beneficial in combating systemic infection.
– Managing preexisting eye conditions tightly so corneas, nerves, tear ducts etc are as healthy as possible if you contract the virus.
– Staying hydrated and using blinking exercises to keep ocular surface lubricated.
– Monitoring for vision changes and urgently contacting an ophthalmologist if any alarming symptoms arise.
The jury is still out on whether topical antivirals, antibiotics, or other prophylactic eye drops are truly preventive against Covid complications. But diligent hygiene and optimal control of existing eye conditions seem prudent. Overall prompt systemic treatment of Covid-19 itself remains the best safeguard against ocular effects.
The bottom line
While COVID-19 predominantly affects the respiratory system, ocular complications are possible in around 30% of patients based on existing research. Pink eye is most common, but general irritation, dryness, pain, and inflammation can manifest at some point during infection. More serious effects like vision loss are possible but quite rare. Mild symptoms usually resolve within weeks with conservative treatment, but immediate ophthalmologic care is key if you experience sudden changes in vision. Practicing hand hygiene, controlling preexisting eye conditions, staying hydrated, and avoiding eye irritants may help reduce risk. But prompt systemic treatment to control Covid infection remains the best way to mitigate effects throughout the body, including the eyes.