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Is there a connection between red eyes and coronavirus?

woman wearing a surgical mask who has coronavirus red eyes

New evidence is emerging that eye redness might be a symptom of COVID-19, the disease caused by the novel coronavirus.

On March 23, 2020, CNN reported that a nurse at a nursing home in Kirkland, Washington, recalled red eyes being a clinical sign in some elderly residents who had developed COVID-19. Twenty-nine people associated with the nursing home died from coronavirus complications, including 18 residents of the nursing home.

"It's something that I witnessed in all of them (the patients)," Chelsey Earnest told CNN. "They have, like, um — you can describe it like allergy eyes. The white part of the eye is not red. It's more like they have red eye shadow on the outside of their eyes."

"But we've had patients that just had red eyes as the only symptom that we saw, and go to the hospital and pass away in the hospital," Earnest said. Despite this observation from the early outbreak of COVID-19 among nursing home residents in Kirkland, it may be that red eyes are not a common or reliable symptom of the disease. It appears the connection between red eyes and COVID-19 is not a widespread phenomenon with the disease.

"In terms of a red shadow around the eyes, not on the white of the eyes, there is not enough data currently to suggest this is a symptom of COVID-19," Dr. Sonal Tuli, a clinical spokeswoman for the American Academy of Ophthalmology (AAO), told Today.com.

As of August 14, the Centers for Disease Control and Prevention (CDC) does not list red eyes among its list of COVID-19 symptoms.

SEE RELATED: COVID-19 and sore eyes

Pink eye and coronavirus

COVID-19 may cause pink eye, or conjunctivitis — inflammation of the clear tissue covering the white part of the eye and lining the inside of the eyelids — but only in about 1% to 3% of infected people, according to AAO. Symptoms of conjunctivitis include eye redness and irritation.

The virus may be spread to the eyes by touching or rubbing your eyes with fingers that have become contaminated by the coronavirus.

AAO says patients seeking treatment for conjunctivitis might be infected with COVID-19 if they also show these symptoms:

  • Fever

  • Cough

  • Shortness of breath

Conjunctivitis and COVID-19 research

AAO cites two recently published studies that have looked into a possible connection between conjunctivitis and COVID-19:

A study published in the Journal of Medical Virology looked at 30 patients hospitalized in China for treatment of COVID-19. One of the patients had coronavirus identified in eye secretions. The researchers say this could mean the virus can infect the conjunctiva and cause conjunctivitis. Viral loads are most often identified in and transmitted through mucous membranes.

In a study published in the New England Journal of Medicine, researchers discovered “conjunctival congestion” in nine of 1,099 patients with COVID-19. It’s worth noting that those with “conjunctival congestion” represented just 0.8% of the confirmed COVID-19 cases.

Meanwhile, a JAMA Ophthalmology study published March 31, 2020, showed 12 of 38 COVID-19 patients treated Feb. 9-15, 2020, at a hospital in China had symptoms consistent with conjunctivitis. For one patient, conjunctivitis was the first symptom. 

Based on this early evidence, the ophthalmology group warns that patients with conjunctivitis “could represent cases of COVID-19.” Therefore, ophthalmologists and optometrists might be the first health care providers to evaluate patients possibly infected with COVID-19.

As explained by Rady’s Children Hospital–San Diego, viruses are the most common cause of conjunctivitis. Viral conjunctivitis may affect both eyes. Symptoms normally last five to seven days and include:

  • Redness in the whites of the eyes

  • Eyelid swelling

  • A sandy, gritty feeling in the eye

  • Tearing

  • Watery or slightly thick, whitish drainage

Dr. Chris Stansbury, an optometrist at West Virginia Eye Consultants, told TV station WCHS that if you suspect you have conjunctivitis, you should contact your eye doctor.

“I would not recommend going to the ER, because there you may come into contact with people who actually have coronavirus,” Stansbury says. “We can look at the eyes and begin to differentiate. Is it allergic? Viral? Bacterial? And then we’ll know how to treat you.”

Be sure to call or email your eye doctor before heading to his or her office. Amid the COVID-19 pandemic, office hours and protocols have changed. Some eye doctors are now diagnosing patients via virtual visits and telemedicine.

SEE RELATED: Are red eyes from coronavirus or allergies?

Pink eye is contagious

Keep in mind that common pink eye is highly contagious. It’s spread through contact with the eye secretions, which contains the virus (or bacteria) that causes conjunctivitis, the San Diego children’s hospital says.

“If you touch an infected eye, and then touch your other eye or an object while you have drainage on your hand, the virus or bacteria can be spread,” the hospital says.

Health experts primarily blame poor hand washing for the spread of pink eye. Sharing objects such as towels, washcloths, contact lens equipment, eye makeup and eye medicine with a person who has pink eye also can spread the infection, the children’s hospital says.

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