Ophthalmologists at private hospitals have been noticing that some people who come in with complaints of conjunctivitis develop COVID-19. They say it is likely to be the earliest sign of the novel coronavirus infection, which could often be missed.
During the second wave of COVID-19, ophthalmologists found out that conjunctivitis could be the first sign of COVID-19, said Mohan Rajan, chairman and medical director of Rajan Eye Care Hospital.
“Conjunctivitis spreads through contact. COVID-19 infection has also been found to spread through contact,” he explained.
Five tested positive
As early as mid-April, cases surfaced at the hospital. Of the 10 patients screened for conjunctivitis, five tested positive for COVID-19. They had no symptoms such as fever, cough or cold. “What we see is the tip of the iceberg. Viral conjunctivitis is caused by adenovirus. It spreads through contact and very easily in closed spaces and air-conditioned rooms. The adenoviral infection is self-limiting and not a threat to sight or life,” he said.
The SARS-CoV 2 virus that causes COVID-19 spreads through aerosol, too, but brings forth other symptoms, such as sore throat and fever. It is fatal sometimes. “Generally, ophthalmologists are in close proximity while examining a patient through a slit lamp biomicroscope. Hence, we use the simple acrylic sheet, which will prevent direct exposure from the patient,” Dr. Mohan explained.
“Before the lockdown, we saw 25-30 patients in three weeks. There were more patients in March and April. We used to see one or two cases daily. We took 15 cases of red eye and did RT-PCR tests... Of them, six were positive. Early diagnosis led to home quarantine, and they did not need hospitalisation,” he said.
Aravind Eye Care Hospital, Puducherry, which covers several districts of Tamil Nadu, has also handled such cases.
Chief medical officer R. Venkatesh said the father of a patient tested positive and two patients had complaints of body ache. None reported symptoms such as fever, diarrhoea, cough or cold.
Amar Agarwal, chairman of Dr. Agarwal’s Eye Hospital, said, “This is the first sign of COVID-19. Lots of patients with red eye have turned out to be COVID-19-positive.”
At Sankara Nethralaya, more patients have been coming in for treatment of mucormycosis, a fungal disease, said vice-chairman T.S. Surendran. The referral hospital has been receiving patients from north India for the condition.
K. Tiruvenkatakrishnan, head of the cornea department, Aravind Eye Hospital, Chennai, reasoned that the stigma attached to the infection prevented patients from revealing the history. “We see swelling of the lids and the conjunctiva, and cellulitis [inflammation of the eyeball]. Conjunctivitis usually presents as discharge in which the conjunctiva will be red. But these patients are coming with lid oedema and eyeball inflammation. We think this could be due to the adenoviral feature, but this can be attributed to [the] post-vaccination [development] as the Covishield vaccine has an adenoviral component,” he said.
