Is Pink Eye A Symptom Of COVID 19?

Coronavirus pandemic started in December 2019 and since then has affected a million people worldwide. It is caused by SARS coronavirus 2 (SARS-COV-2).⁽¹⁾

COVID-19 is a highly contagious respiratory illness that can cause mild to severe symptoms in those suffering from it. According to the World Health Organization (WHO) the symptoms of COVID-19 infection include:⁽²⁾

About 1-3 percent of people may also have a pink eye as a symptom.⁽³⁾

Pink Eye and COVID-19

Pink eye is also known as conjunctivitis. It is the inflammation of the white of the eye and inside the eyelids.⁽⁴⁾ It is caused by bacteria or viral infection and can lead to redness and swelling in the eye.

A study was done to examine the prevalence of pink eye in COVID-19 patients. It was found that about 1.1 percent of people developed pink eye and was seen occurring more in those with severe symptoms.⁽⁵⁾

Chemosis and COVID-19

Chemosis is a type of eye inflammation that can lead to swelling in the eye lid.
A study done on people hospitalized because of COVID-19 found 12 participants to have a pink eye. Amongst those 12, 7 experienced chemosis⁽⁶⁾
Chemosis can also be due to pink eye or eye irritation.

Epiphora and COVID-19

Epiphora is a term used for watery eyes that can be due to excessive tear production.

A study done on people hospitalized for COVID-19, found that seven people had epiphora as a symptom.⁽⁶⁾ Amongst them, few of the participants experienced epiphora as the first symptom of COVID-19.

The Link Between COVID-19 and Opthalmological Symptoms

The coronavirus is transmitted through droplets in the air. These droplets occur when somebody sneezes, speaks or coughs. When somebody breathes in these droplets, the virus gains entry into their body.

The virus can also gain access to the body when you touch surfaces on which the droplets are landed.

The virus causing COVID-19 is genetically similar to the virus that caused the 2003 SARS outbreak. Research on the SARS outbreak found lack of eye protection put healthcare workers in Toronto at health risk.⁽⁷⁾ Though the chances suggested were very low, but taking precautions to protect the eye is a good idea.

How Does Coronavirus Get Into The Eyes?

2003 SARS virus enters the human body through an enzyme known as angiotensin-converting enzyme 2 (ACE2), and so does COVID-19.⁽⁸⁾

ACE2 can be found throughout the body including the kidney, intestine, heart, lungs, and has also been detected in the human retina.

The virus enters the cells tricking the cells for it being ACE2 and attaches to the cell at receptor spot. Once the virus gets into the cell it replicates until it ruptures the cells and the copies of it invade new cells and repeat the process.

The virus on reaching the eyes, cause a pink color to it.

How To Protect Eyes From Coronavirus?

Protecting the eye from airborne respiratory droplets can help protect from COVID-19 disease.

Eyes can be protected by:

Wearing glasses instead of contact lens
Shield the eyes by wearing sunglasses
Avoiding rubbing of the eyes
Washing hands frequently
Avoiding touching face
Practice social distancing
Wear a mask in public

When To See A Doctor?

If you have a pink eye it does not mean you are suffering from COVID-19.

There are other reasons which might cause the eye to turn pink, such as:

A foreign object in the eye
Digital eye strain
Allergies
The eye symptoms of COVID-19 are mostly mild and clear up with eye drops.
It is necessary to consult a doctor if other symptoms of the disease exist.

If the symptoms are mild, avoid going to the hospital to reduce the risk of transmitting the disease. About 80% of people are known to have mild symptoms (9). In case of emergency symptoms, contact a healthcare provider right away. Emergency symptoms include:

Difficulty in breathing
Chest pain
Blue lips
Confusion
Inability to wake

Pink eye is not a common sign of coronavirus disease. It can be minimized by taking the necessary precautions and practicing social distancing.

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Is Pink Eye A Symptom Of COVID 19?