An editorial in the British Journal of Ophthalmology, co-authored by ophthalmologists from Hong Kong and mainland China, Singapore and the UK advocates that healthcare workers use eye protection, in addition to gloves and masks, when examining patients’ eyes. The authors base their advice on evidence suggesting that the eyes can be a route through which people can become infected by COVID-19 virus and that infected eyes may be a source of infection to others.
The case of a healthcare worker who was a member of the expert task force who visited Wuhan demonstrates the possibility of the eye as a route of infection with the COVID-19 virus, the authors point out. Despite being fully gowned with protective suit and N95 respirator mask, he was infected by the virus with unilateral conjunctivitis as the first symptom, followed by development of fever a few hours later. Healthcare professionals in China have been urged to use eye protection when they are in close contact with patients.
The authors note that although there are no reports in the literature of ocular manifestations of infection with the related viruses MERS-CoV or SARS-CoV11-13, polymerase chain reaction (PCR) testing has shown presence of the virus in tears from patients with SARS-CoV infection. In addition, there is evidence that some other types of coronavirus can cause conjunctivitis in humans. For example, human coronavirus NL 63 (HCoV-NL63) was first identified in a baby with bronchiolitis and conjunctivitis and conjunctivitis was present in five (17%) of 28 Subsequent paediatric cases with confirmed HCoV-NL63 infections of children.
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