Dry eyes can be a symptom of coronavirus disease 19 (COVID-19), as can other eye symptoms, such as soreness and sensitivity to light. Eye dryness can also stem from many other factors, including some related to the pandemic, such as wearing a face mask and having more screen time.

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If a person has dry eyes but no other symptoms of COVID-19, the dryness may result from another cause.

This article looks at the link between dry eyes and COVID-19. It also explores other eye-related symptoms of the disease, other causes of dry eyes, treatment options, and when to contact a doctor.

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A 2021 review suggests that around 1 in 10 people with COVID-19 have symptoms affecting their eyes. One of these symptoms is dryness.

Dry eyes can be a symptom of the disease, but the reason for this is still unclear. Research from 2020 suggests a link between COVID-19 and angiotensin converting enzyme 2 (ACE2).

Researchers found ACE2 in cells of the conjunctiva, the membrane covering the front of the eye and the inside of the eyelid. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19 symptoms, binds to ACE2 to enter and infect cells.

Meanwhile, according to the National Eye Institute, dry eyes are a common issue, affecting millions of people in the United States each year. If someone has no other symptoms of COVID-19, the dryness may stem from another cause.

Indirect effects of the pandemic can also cause dry eyes.

A 2020 study suggests wearing face masks may contribute to dry eyes. If a mask does not fit properly or shifts out of place, it could allow the air that a person breathes out to circulate around their eyes. This can lead to a quicker evaporation of tears, drying out the eyes.

This effect of an ill-fitting face mask may be a milder version of what can happen when using a continuous positive airway pressure (CPAP) machine. CPAP is a therapy for sleep apnea. It involves wearing a mask through which air flows continuously to keep the airways open during sleep. This can increase eye irritation and evaporation of tears.

The study also suggests that increased screen time during the pandemic could lead to dry eyes. Looking at a screen causes people to blink less frequently, which increases the evaporation of tears.

To counter these effects, the researchers recommend blinking more frequently when using screens and wearing a correctly fitting face mask.

Mask recommendations

The CDC recommends that people who are not fully vaccinated wear cloth face masks in indoor public settings. If case numbers are high in the area, it may be best to wear a mask outdoors, as well.

This will help slow the spread of the virus from people who do not know that they have contracted it, including those who are asymptomatic. Note: It is critical that surgical masks and N95 respirators are reserved for healthcare workers.

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According to a 2020 questionnaire-based study that included 83 participants with confirmed COVID-19, the most common eye symptoms were:

  • photophobia, or light sensitivity, in 18% of the participants
  • itchy eyes, in 17%
  • sore eyes, in 16%

For 81% of the respondents, the eye symptoms occurred within 2 weeks of other COVID-19 symptoms. For 80%, the eye symptoms did not last longer than 2 weeks.

The 2021 systematic review notes that reported eye-related symptoms vary. They include:

  • tearing
  • discharge
  • blurred or decreased vision
  • conjunctivitis
  • the sensation of having a foreign object in the eye
  • chemosis — inflammation and swelling that may cause itchiness and trouble seeing

Most people may find that eye symptoms related to COVID-19 resolve without treatment within a few weeks.

Over-the-counter artificial tear products may treat the dryness. For people who use these products frequently, preservative-free options may cause less irritation.

If artificial tears do not relieve the symptoms, speak with a doctor about other approaches, such as prescription eye drops.

A person can also try the following ways to help relieve dry eyes:

  • if possible, avoid smoke, direct air flow, and wind
  • drink 8–10 glasses of water per day
  • use a humidifier to keep the air from drying out
  • use warm compresses on the eyes

Some allergies can cause symptoms similar to those of COVID-19, including eye dryness and irritation.

Allergies may cause one or more of the following eye symptoms:

  • itchiness
  • redness
  • watering
  • a burning sensation

Although some symptoms of eye allergies and COVID-19 overlap, the CDC notes that the following are more likely to result from allergies:

  • watery eyes
  • itchy eyes
  • sneezing

Learn more about how to differentiate between COVID-19 and allergy symptoms here.

Other causes of dry eyes can include problems with tear production and quality, such as:

  • the tear glands not producing enough tears
  • problems with the layers of tears, or tear film, causing tears to evaporate too quickly
  • tears not coating the eye properly

Overall, if people have no other symptoms of COVID-19, dry eyes may stem from another cause.

Anyone with symptoms that overlap with those of COVID-19, such as flu-like symptoms, should follow local public health guidelines and take a COVID-19 test.

As the CDC notes, symptoms of COVID-19 include:

  • a new, persistent cough
  • fever or chills
  • a loss of taste or smell
  • shortness of breath
  • fatigue
  • muscle aches
  • a headache
  • a sore throat
  • congestion or a runny nose
  • nausea
  • vomiting
  • diarrhea

The CDC advises people to keep track of their symptoms and stay at home. However, a person should receive immediate medical care if they experience any of the following severe COVID-19 symptoms:

  • difficulty breathing
  • persistent chest pain or pressure
  • a new state of confusion
  • an inability to stay alert or awake
  • a change in skin tone, such as if the lips, skin, or nail beds become unusually pale, gray, purple, or blue

It is important to let the medical team know in advance that the person who needs care may have COVID-19. This allows them to take any necessary precautions.

Dry eyes and other eye issues, such as soreness and sensitivity to light, can be symptoms of COVID-19.

If a person has no other COVID-19 symptoms, such as a persistent cough or loss of taste or smell, the dryness may stem from another cause. It is a common issue that can result from some allergies and various other factors.

Using an over-the-counter artificial tear product may relieve the dryness, as may drinking more water, using a humidifier, and making sure that face masks fit properly. If these approaches do not help, a healthcare professional can describe further treatment options.

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