World Health Organization High Priority Pathogens: Ophthalmic Disease Findings and Vision Health Perspectives

Abstract

Recent Ebola epidemics, the ongoing COVID-19 pandemic, and emerging infectious disease threats have highlighted the importance of global infectious diseases and responses to public health emergencies. Ophthalmologists are essential health care workers who provide urgent and emergent vision care services during outbreaks and address the ocular consequences of epidemic and pandemic infectious diseases. In 2017, the World Health Organization (WHO) identified high priority pathogens likely to cause a future epidemic with the goal of guiding research and development to improve diagnostic tests, vaccines, and medicines. These measures were necessary to better inform and respond to public health emergencies. Given the ocular complications associated with emerging infectious diseases, there is a need to recognize the ophthalmic sequelae for future vision health preparedness for potential future outbreaks. The WHO High Priority pathogens list provides a roadmap for ophthalmologists and subspecialty providers that will guide strategic areas of research for clinical care and preparedness for future pandemic threats. This review summarizes these key viral pathogens, summarizes major systemic disease findings, and delineates relevant ocular complications of the WHO High Priority pathogens list, including Crimean-Congo hemorrhagic fever, Filovirus diseases (Ebola virus disease and Marburg hemorrhagic fever), human Coronaviruses, Lassa Fever, Nipah virus infection, Zika, and Rift Valley fever.

Keywords: COVID-19; anterior uveitis; ebola survivor; ebola virus disease; emerging infectious disease; marburg virus disease; ophthalmic manifestations; ophthalmic sequalae; posterior uveitis; retinitis; tear film transmission; uveitis; viral persistence.

Figure 1

Anterior segment photographs of Ebola virus disease (EVD) survivors show keratic precipitates, posterior synechiae, and cataract due to untreated uveitis (A). High magnification of another EVD survivor shows diffuse posterior synechiae and dense cataractous lens which can develop from untreated uveitis or as a side effect of corticosteroid used to treat uveitis (B).