COVID-19 and the Ocular Surface: A Review of Transmission and Manifestations

Ocul Immunol Inflamm. 2020 Jul 3;28(5):726-734. doi: 10.1080/09273948.2020.1772313. Epub 2020 Jun 16.

Abstract

Purpose: The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reached pandemic proportions within an unprecedented span of time. It is controversial whether the virus can be transmitted via tears and its ocular implications have not been widely studied. In this article, the current evidence related to ocular transmission and ocular manifestations is reviewed.

Results: Several mechanisms for the ocular transmission of the virus are proposed with highlight on the nasolacrimal system as a conduit between the eye and the respiratory tract, and the role of the lacrimal gland in hematogenous spread. Ocular surface manifestations such as conjunctivitis are more commonly reported.

Conclusion: The exact pathophysiology of ocular transmission of the virus remains incompletely understood, although there is preliminary evidence of SARS-CoV-2 being detected in ocular secretions. The ocular tropism of the virus and its potential to cause localized ocular disease are worth considering.

Keywords: COVID-19; conjunctivitis; ocular surface; sars CoV-2.

Publication types

  • Review

MeSH terms

  • Betacoronavirus* / isolation & purification
  • COVID-19
  • Conjunctivitis, Viral / epidemiology
  • Conjunctivitis, Viral / transmission*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / transmission*
  • Cross Infection / transmission
  • Disease Outbreaks
  • Eye Infections, Viral / epidemiology
  • Eye Infections, Viral / transmission*
  • Humans
  • Pandemics
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / transmission*
  • SARS-CoV-2
  • Tears / virology