COVID-19 pandemic from an ophthalmology point of view

Abstract

Coronavirus disease 2019 (COVID-19) is caused by a highly contagious RNA virus termed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Ophthalmologists are at high-risk due to their proximity and short working distance at the time of slit-lamp examination. Eye care professionals can be caught unaware because conjunctivitis may be one of the first signs of COVID-19 at presentation, even precluding the emergence of additional symptoms such as dry cough and anosmia. Breath and eye shields as well as N95 masks, should be worn while examining patients with fever, breathlessness, or any history of international travel or travel from any hotspot besides maintaining hand hygiene. All elective surgeries need to be deferred. Adults or children with sudden-onset painful or painless visual loss, or sudden-onset squint, or sudden-onset floaters or severe lid oedema need a referral for urgent care. Patients should be told to discontinue contact lens wear if they have any symptoms of COVID-19. Cornea retrieval should be avoided in confirmed cases and suspects, and long-term preservation medium for storage of corneas should be encouraged. Retinal screening is unnecessary for coronavirus patients taking chloroquine or hydroxychloroquine as the probability of toxic damage to the retina is less due to short-duration of drug therapy. Tele-ophthalmology and artificial intelligence should be preferred for increasing doctor-patient interaction.

Keywords: Chloroquine - contact lens - coronavirus - eye donation - eye shields - hydroxychloroquine - ophthalmologist.

Fig. 1

Ophthalmological signs and symptoms of coronavirus disease 2019. Chemosis, conjunctival congestion, follicles, tearing, itching, dry eye, blurred vision, photophobia and preauricular lymphadenopathy are major signs.

Fig. 2

A summary of potential strategies in hygiene practices, personal protective equipment and non-pharmacological interventions for the prevention of infection among the ophthalmologists and patients visiting ophthalmology clinics.