Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Apr 24:8:155.
doi: 10.3389/fpubh.2020.00155. eCollection 2020.

Role of the Eye in Transmitting Human Coronavirus: What We Know and What We Do Not Know

Chuan-Bin Sun  1 , Yue-Ye Wang  1 , Geng-Hao Liu  1 , Zhe Liu  2
Affiliations
Review

Role of the Eye in Transmitting Human Coronavirus: What We Know and What We Do Not Know

Chuan-Bin Sun et al. Front Public Health. .

Abstract

The outbreak of the current 2019 novel coronavirus (2019-nCoV, now named SARS-CoV-2) infection has become a worldwide health threat. Currently, more information is needed so as to further understand the transmission and clinical characteristics of 2019-nCoV infection and the infection control procedures required. Recently, the role of the eye in transmitting 2019-nCoV has been intensively discussed. Previous investigations of other highly infectious human CoVs, that is, severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), may provide useful information. In this review, we describe the genomics and morphology of human CoVs, the epidemiology, systemic and ophthalmic manifestations, and mechanisms of human CoV infection, and recommendations for infection control procedures. The role of the eye in the transmission of 2019-nCoV is discussed in detail. Although the conjunctiva is directly exposed to extraocular pathogens, and the mucosa of the ocular surface and upper respiratory tract are connected by the nasolacrimal duct and share the same entry receptors for some respiratory viruses, the eye is rarely involved in human CoV infection, conjunctivitis is quite rare in patients with 2019-nCoV infection, and the CoV RNA positive rate by RT-PCR test in tears and conjunctival secretions from patients with 2019-nCoV and SARS-CoV infection is also extremely low. This suggests that the eye is neither a preferred organ of human CoV infection nor a preferred gateway of entry for human CoVs for infecting the respiratory tract. However, pathogens that the ocular surface is exposed to might be transported to nasal and nasopharyngeal mucosa by constant tear rinsing through the lacrimal duct system and then cause respiratory tract infection. Considering that close doctor-patient contact is quite common in ophthalmic practice and is apt to transmit human CoVs by droplets and fomites, strict hand hygiene and proper personal protection are highly recommended for health care workers to avoid hospital-related viral transmission during ophthalmic practice.

Keywords: 2019-nCoV; Coronavirus; SARS-CoV-2; conjunctiva; conjunctivitis; eye; infection; transmission.

PubMed Disclaimer

References

    1. Chen Y, Liu Q, Guo D. Emerging coronaviruses: Genome structure, replication, and pathogenesis. J Med Virol. (2020) 92:418–423. 10.1002/jmv.25681 - DOI - PMC - PubMed
    1. Swerdlow DL, Finelli L. Preparation for possible sustained transmission of 2019 novel coronavirus: lessons from previous epidemics. JAMA. (2020) 323:1129–30. 10.1001/jama.2020.1960 - DOI - PubMed
    1. Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. . A new coronavirus associated with human respiratory disease in China. Nature. (2020) 579:265–9. 10.1038/s41586-020-2008-3 - DOI - PMC - PubMed
    1. Belser JA, Rota PA, Tumpey TM. Ocular tropism of respiratory viruses. Microbiol Mol Biol Rev. (2013) 77:144–56. 10.1128/MMBR.00058-12 - DOI - PMC - PubMed
    1. Pedrosa PBS, Cardoso TAO. Viral infections in workers in hospital and research laboratory settings: a comparative review of infection modes and respective biosafety aspects. Int J Infect Dis. (2011) 15:e366–76. 10.1016/j.ijid.2011.03.005 - DOI - PMC - PubMed

Publication types