Case study links Covid 19 with follicular conjunctivitis

In some studies patients with COVID-19, have reportedly had ocular manifestations, such as epiphora, conjunctival congestion, or chemosis, and these commonly occurred in patients with more severe systemic manifestations.

Researchers have reported follicular conjunctivitis in a patient of Covid 19 while describing the ocular characteristics and presence of viral RNA in a patient . The case has been published in the British Journal of Ophthalmology.

The case report describes the clinical ocular manifestations of a 30-year-old male with COVID-19 in Shenzhen, China. The man presented with typical systemic symptoms and was diagnosed with bilateral acute conjunctivitis 13 days after illness onset.

After initially presenting with a sore throat and diarrhea, the patient tested positive for SARS-CoV-2 and developed pulmonary symptoms. His vital signs stabilized after beginning treatment with various medications including umifenovir, lopinavir and ritonavir on day 6 and beyond.

On day 13, the patient developed redness of both eyes along with foreign body sensation and tearing. Visual acuity was not significantly affected. Slit lamp examination revealed bilateral moderate conjunctival injection, watery discharge, inferior palpebral conjunctival follicles and tender palpable preauricular lymph nodes. Conjunctival swabs tested positive on RT-PCR for SARS-CoV-2. The patient was prescribed ribavirin eye drops and showed a decrease in conjunctival viral load on day 17. All ocular symptoms resolved by day 19, which coincided with negative conjunctival RT-PCR test results.

Since this is a case report, it is unclear whether the ribavirin eye drops contributed to the resolution of this patient's ocular SARS-CoV-2 infection.

This case suggests that SARS-CoV-2 RNA can be present during active infection of the conjunctiva, resulting in acute follicular conjunctivitis. The viral RNA levels in this patient's conjunctival specimens were much lower than in the respiratory samples and appeared to gradually decrease over the 5-day course of conjunctivitis.

SARS-CoV-2 is capable of causing ocular complications such as viral conjunctivitis in the middle phase of illness. Precautionary measures are recommended when examining infected patients throughout the clinical course of the infection. However, conjunctival sampling might not be useful for early diagnosis because the virus may not appear initially in the conjunctiva.

The data may assist ophthalmologists and others to understand the ocular manifestations of COVID-19, thus enhancing the diagnosis and prevention of the transmission of the disease.

For further reference log on to:

Chen L, Liu M, Zhang Z, et alOcular manifestations of a hospitalised patient with confirmed 2019 novel coronavirus disease

British Journal of Ophthalmology Published Online First: 07 April 2020. doi: 10.1136/bjophthalmol-2020-316304