Possible early ocular signs
Evidence shows that some coronavirus infections can occasionally cause conjunctivitis in humans. In fact, in 2004 another coronavirus, NL-63, was first identified in a baby with bronchiolitis and conjunctivitis.18
In 28 cases subsequently confirmed in French children with coronavirus NL-63, 17 percent had conjunctivitis.19 Although in the initial clinical reports of 150 patients with COVID-19 conjunctivitis has not been observed clinically, it cannot be excluded because it is known a coronavirus has been recognized to cause conjunctivitis.18
As of Feb. 10, information emerged identifying the conjunctiva as an alleged route of exposure. COVID-19 may enter the body through the eyes and spread via the superficial conjunctival blood vessels to the entire body.16 As these patients may present with a viral conjunctivitis, it is important for eyecare professionals to inquire about travel history, family history, and systemic flu-like symptoms.
COVID-19 may cause other ocular signs and symptoms, including photophobia, irritation, conjunctival injection, and a watery discharge. These signs are predominantly self-limiting but may require supportive care. Ocular tears and discharge are a potential contamination source, and the eye is likewise a route of exposure.16
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