Ophthalmology and COVID19

Ophthalmology and COVID19

Radial interview to Dr. Christian Sancho, cornea and anterior segment specialist of Clinica Sancho, about eye care and eye symptomatology due to COVID 19.

How COVID can be transmitted to the eyes? What is the eye symptomatology and how is disease process?

What is reported until now in the medical studies, is that the transmission is like a regular conjunctivitis, what it means is that the infection can be spread by the hands and touching the eyes; this is one of the ways that is reported. Another way is the coughing of a person with COVID that can also produce conjuntivitis.

About the symptomatology the patient can present conjuntival hyperemia (red eyes) similar to any other conjunctivitis.

What is the percentage of infection at the ophthalmological level?

According to the reports until now 1/3 of the population with COVID can have conjunctivitis specially the more severe cases. We have to understand that the virus can affect every patient in a different way; some can be asymptomatic, others have really few symptomatology and the more sever cases can even need intensive care with ventilators.

What is the eye symptomatology?

The patient presents with red eye, what is unusual, is that it affects mainly one eye and there is not secretions compare to other conjunctivitis.

The clinical presentation is diffuse red eye with photophobia (light bothers the patient), these is the symptomatology that is reported until now by Europe and China.

The area of the face and eyes are more vulnerable because people are used to touch or manipulate any object and then touch the face and eyes. What kind of hygienic measures should be taken?

Worldwide there are biosecurity measurements that everybody must take like avoid touching the face and eyes, to wash hands frequently, to use antibacterial gel with the proper alcohol concentration, wearing face masks, the use of protective glasses or protective face shields, all of these will help us to prevent the infection. The main message here is hygiene.

Could the use of steam baths and sauna be an option to eliminate the virus?

No, there is not relation with the use of humid areas or high temperatures in the treatment of COVID, maybe people think that high temperatures may kill the virus or help them breath better but that is not true.

How to differentiate if I have conjunctivitis or I have been infected with COVID?  Specially if there are not other symptoms.

As I mention previously it can present just in one eye with diffuse red eye meaning that some areas of the eye are more red than others, also patients can complain of some pain when they move the eye and the secretion may be minimal or absent. Most of the conjunctivitis have secretion or mucus but in COVID conjunctivitis do not work like that.

The only way to know if a patient has COVID specially if he is asymptomatic is the use of rapid tests or in the case that the patient refers that was in contact with someone positive to COVID.

What we can do if a child has red eye for several days?

We have to determinate several factors like the age of the child, if it presents in one or both eyes, if it has secretions, if there is pain, if there is tearing, etc.

If the eye is just minimally red and no other symptom it is not an emergency but if the redness continue the parents should search for ophthalmological attention. We are offering telemedicine that can be a good option.

In this quarantine all of us are spending a lot of time using computers, television and cellular phones. What recommendations you can give us to lubricate the eyes if people do not have drops or lubrication gel at home?

The exposure for long periods of time to screens can produce eye problems. First of all we have to know that there are different types of screens, the television, cellular phones and computers are not the same.

The new technology use LED light, this light produces the famous toxicity to blue light. People should find and activate in their cellular phones or tablets the option “protection to blue light”. The new televisions come with this protection.

As much time we use the screens the eye symptoms will be more severe, if you do not have eye drops that will be the best option, patients can do what we call active pause what it means is to rest 15 or 20 minutes from the computer changing the activity, closing the eyes for few minutes or to blinking several times. Another option is to use cool compresses or to wash the face with cold water.

Swimming glasses can be used as protection to COVID -19?

Is not the best option because they can fog up and produce some discomfort in the eyes. We have to remember that this type of glasses use a suction cup mechanism and I do not think is the best option to protect ourselves.

What we can use to protect our eyes from COVID -19?

We can use facial mask, gloves, and protective glasses to prevent the contact of the virus.  Worldwide are using these protective measurements.

If we have any product like alcohol to disinfect the area we area or when we area in contact with other people can be very useful.

What should I do to avoid the infection?

The best advise is to stay at home, however if you need to go out, the best advise is to use all the biosecurity measurements that we mention previously like the use of facial mask, protective glasses, to wash properly the hands as the OMS recommendations, the use of gel with the proper alcohol concentrations and to maintain 2 meters of distance between people.

When do you recommend that a patient with eye symptoms should visit your office?

If there is an emergency currently we have telemedicine as the first option, is what we have been doing in some cases.  However if the discomfort persist, the eye is too red, there is pain in the eye, there is a foreign body in the eye, any eye accident, progressive visual lost or sudden visual lost, all of these are emergencies so they have to visit an ophthalmologist.