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The Ocular Manifestations and Transmission of COVID-19: Recommendations for Prevention.
J Emerg Med. 2020 07; 59(1):137-140.JE

Abstract

BACKGROUND

Coronavirus disease-2019 (COVID-19), caused by a novel coronavirus termed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been linked to ocular signs and symptoms in several case reports. Research has demonstrated that SARS-CoV-2 is spread primarily through close contact via respiratory droplets, but there is the possibility for ocular transmission, with the conjunctiva as a conduit as well as a source of infection.

DISCUSSION

Ocular manifestations of SARS-CoV-2 include follicular conjunctivitis, and have been repeatedly noted as an initial or subsequent symptom of COVID-19-positive patients. Particularly in patients with ocular manifestations, there is evidence that the virus may present in tears, based on the detection of SARS-CoV-2 in conjunctival swab samples via reverse transcription polymerase chain reaction. The virus may therefore be transmittable from the ocular surface to a new host via contact with the ocular mucosa, tears, or subsequent fomites.

CONCLUSIONS

All health care professionals should ask patients about ocular symptoms consistent with SARS-CoV-2, and use eye protection such as goggles or face shields as part of the standard personal protective equipment for high-risk patients in addition to wearing of masks by both the patient and provider, and should consider tears to be potentially infectious.

Links

PMC Free PDF

Authors+Show Affiliations

Dockery DM
Department of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Rowe SG
Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts.
Murphy MA
Department of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Krzystolik MG
Department of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Department of Ophthalmology (Retina Section), Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.

MeSH

BetacoronavirusCOVID-19CoronavirusCoronavirus InfectionsHumansPandemicsPneumonia, ViralSARS-CoV-2Tropism

Pub Type(s)

Journal Article
Comment

Language

eng

PubMed ID

32456959

Citation

Dockery, Dominique M., et al. "The Ocular Manifestations and Transmission of COVID-19: Recommendations for Prevention." The Journal of Emergency Medicine, vol. 59, no. 1, 2020, pp. 137-140.
Dockery DM, Rowe SG, Murphy MA, et al. The Ocular Manifestations and Transmission of COVID-19: Recommendations for Prevention. J Emerg Med. 2020;59(1):137-140.
Dockery, D. M., Rowe, S. G., Murphy, M. A., & Krzystolik, M. G. (2020). The Ocular Manifestations and Transmission of COVID-19: Recommendations for Prevention. The Journal of Emergency Medicine, 59(1), 137-140. https://doi.org/10.1016/j.jemermed.2020.04.060
Dockery DM, et al. The Ocular Manifestations and Transmission of COVID-19: Recommendations for Prevention. J Emerg Med. 2020;59(1):137-140. PubMed PMID: 32456959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Ocular Manifestations and Transmission of COVID-19: Recommendations for Prevention. AU - Dockery,Dominique M, AU - Rowe,Susannah G, AU - Murphy,Marjorie A, AU - Krzystolik,Magdalena G, Y1 - 2020/05/08/ PY - 2020/04/22/received PY - 2020/04/26/revised PY - 2020/04/28/accepted PY - 2020/5/28/pubmed PY - 2020/9/17/medline PY - 2020/5/28/entrez KW - COVID-19 KW - SARS-CoV-2 KW - conjunctivitis KW - ocular transmission KW - ophthalmic precautions SP - 137 EP - 140 JF - The Journal of emergency medicine JO - J Emerg Med VL - 59 IS - 1 N2 - BACKGROUND: Coronavirus disease-2019 (COVID-19), caused by a novel coronavirus termed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been linked to ocular signs and symptoms in several case reports. Research has demonstrated that SARS-CoV-2 is spread primarily through close contact via respiratory droplets, but there is the possibility for ocular transmission, with the conjunctiva as a conduit as well as a source of infection. DISCUSSION: Ocular manifestations of SARS-CoV-2 include follicular conjunctivitis, and have been repeatedly noted as an initial or subsequent symptom of COVID-19-positive patients. Particularly in patients with ocular manifestations, there is evidence that the virus may present in tears, based on the detection of SARS-CoV-2 in conjunctival swab samples via reverse transcription polymerase chain reaction. The virus may therefore be transmittable from the ocular surface to a new host via contact with the ocular mucosa, tears, or subsequent fomites. CONCLUSIONS: All health care professionals should ask patients about ocular symptoms consistent with SARS-CoV-2, and use eye protection such as goggles or face shields as part of the standard personal protective equipment for high-risk patients in addition to wearing of masks by both the patient and provider, and should consider tears to be potentially infectious. SN - 0736-4679 UR - https://www.unboundmedicine.com/medline/citation/32456959/The_Ocular_Manifestations_and_Transmission_of_COVID_19:_Recommendations_for_Prevention_ DB - PRIME DP - Unbound Medicine ER -