The SARS-CoV-2 pathogen that has swept the globe causing the highly-contagious and sometimes fatal disease Covid-19 has long been known to spread via mucous droplets when coughing or sneezing, but new evidence indicates that the virus could be contracted and spread through fluids from the eyes. A case study, presented by doctors in Italy and published in the journal Annals of Internal Medicine, details a patient who presented with Covid-19 virus secretions from the eyes even after “recovering” from the illness.
The patient in question was a 65-year-old woman who had traveled to Italy from Wuhan. She was admitted to hospital one day after her symptoms began, which included a dry cough, sore throat, a cold, and conjunctivitis in both eyes. Conjunctivitis is an eye infection that causes sore, itchy eyes with a viscous secretion that can “glue” the lashes.
Her persistent conjunctivitis led to the clinicians testing the fluid in her eyes for coronavirus and the swab samples were found to test positive for viral RNA for SARS-CoV-2. This viral RNA persisted in the eye fluid until day 20 of infection, which meant the virus was still present in her eyes five days after a nasal swab came back negative for the disease.
The clinicians concluded that the presence of viral RNA in the ocular fluids indicates that infected patients may be able to spread disease through the secretions from their eyes. The discovery highlights the grave need for adequate personal protective equipment (PPE) for clinical staff who are forced to come into close contact with Covid-19 sufferers. This precaution extends to ophthalmologists as the doctors theorize that the presence of SARS-CoV-2 in the eyes makes them a source of contagion as well as a site for contracting infection. The ocular involvement in this particular patient’s presentation of Covid-19 was seen very early on, indicating that the eyes may well be a source of spread in the early days of the disease’s development.
The clinicians also highlight how the findings stress the importance of individuals not touching their faces. This precaution needs to include avoiding touching the eyes as well as the nose and mouth, in order to prevent spread from viral material transferred to the hands that can survive on surfaces for a long time.
While the conclusions are based on a very small sample, the inclusion of ocular fluid as a means of pathogen spread for Covid-19 had already been considered following a string of infections in people without eye protection at the Wuhan Fever Clinic. There was also evidence of SARS-CoV-2 viral RNA in the tears of an infected patient with conjunctivitis in a hospital in China. However, further investigation is needed to identify the infectious potential of SARS-CoV-2 RNA in eye fluid and to determine for certain if this is a means through which the disease can be caught and spread.
