SARS-CoV-2 is the virus responsible for COVID-19. Individuals with COVID-19 may report a range of symptoms, which continues to grow as experts learn more about the illness. While it is not a common symptom, acquiring an infection with the SARS-CoV-2 virus may lead to a person developing infective conjunctivitis, known as pink eye.

A 2020 study notes that in 216 children with COVID-19, the researchers identified roughly 23% with symptoms of conjunctivitis. However, in adults, this seems to be less common, with evidence suggesting that pink eye can occur in approximately 1–3% of adults with the disease. This may indicate that while pink eye is an uncommon symptom, it is more likely to occur in children with COVID-19.

Aside from pink eye, COVID-19 may also result in other eye problems, which could lead to various symptoms, such as vision loss or eye pain.

In this article, we will discuss the possible associations between eye problems and COVID-19. We also explore how people can protect their eyes.

A person with both COVID-19 and pink eye.Share on Pinterest
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A 2021 article suggests that the prevalence of ophthalmological symptoms — which affect the eyes — in people with COVID-19 may range from 2–32%. While pink eye seems to be one of the more common ophthalmological symptoms, it is still relatively rare, with other sources suggesting that it only occurs in up to 3% of people with the disease. Research also states it is more common in individuals with severe cases of COVID-19.

Symptoms of pink eye can include:

  • a red or pink color in the white of the eye
  • swelling of the conjunctiva, eyelid, or both
  • irritation, itching, or burning
  • eyelid swelling
  • tearing
  • discharge
  • crusting of eyelids or lashes
  • the sensation of a foreign body in the eye

In addition to the conjunctiva, people may also report symptoms in other parts of the eye, such as the optic nerve, retina, pupil, and lacrimal gland. Other eye conditions that may have links with COVID-19 can include:

  • Episcleritis: Refers to inflammation of the episclera, the thin layer of tissue between the conjunctiva and the sclera. While pink eye has commons links with coronaviruses, case reports note that episcleritis can occur with COVID-19. In some cases, signs of episcleritis may present before symptoms of COVID-19.
  • Retinal changes: A 2020 study notes that scientists observed retinal changes in people with COVID-19. These changes to the retina include lesions, cotton wool spots, and bleeding. Other studies add that COVID-19 can also affect retinal veins or result in nodules.
  • Optic neuritis: This refers to inflammation of the optic nerve, which can affect vision. Coronaviruses can inflame the optic nerve in animal models, while studies suggest that SARS-CoV-2 may be capable of doing the same in humans. A case study indicates that SARS-CoV-2 triggers the immune system, resulting in neuritis. Another case study notes that eye pain and vision loss may occur alongside more common symptoms of COVID-19.

Other case studies also report symptoms of:

  • pain with eye movements
  • pupil dilation
  • double vision
  • uncontrolled eye movement
  • excessive watering of the eye

The virus that causes COVID-19 is SARS-CoV-2, a member of the coronavirus family. While they occur more often in animals, coronaviruses can trigger eye conditions in humans. As the eyes have many blood vessels, they can be an easy entry point for viruses.

A 2021 study highlights that the eyes may be an underappreciated but possible route for SARS-CoV-2 transmission. While the evidence notes it is unlikely, people can contract this infection through the eye. Researchers believe that direct contact with the mucous membranes of the eye is the most likely route of transmission.

Therefore, a person may acquire an eye infection with SARS-CoV-2 if they touch a contaminated surface and then touch their eye. It is also possible for SARS-CoV-2 to enter the eye through airborne droplets following a cough or sneeze from a person carrying the virus.

The Centers for Disease Control and Prevention (CDC) emphasize the importance of washing hands, adding that people should avoid touching their nose, mouth, and eyes with unwashed hands. A 2020 study also suggests wearing protective goggles, particularly within healthcare settings.

The American Optometric Association offers the following recommendations to protect the eyes:

  • guarding the eyes and wearing protective eyewear, such as safety glasses
  • avoiding touching the eyes
  • washing hands frequently and avoid touching the eyes with unwashed hands
  • keeping a distance from people who are coughing or sneezing
  • maintaining a distance of at least 6 feet from others
  • cleaning and disinfecting areas that people share, such as light switches, doorknobs, and phones
  • avoiding using contact lens when sick
  • disinfecting lenses according to the manufacturer’s instructions for those who do not use disposable lenses

Causes of conjunctivitis can include an array of viruses and bacteria, including SARS-CoV-2. If this condition is due to SARS-CoV-2, in some cases, it may be the only symptom of the viral infection.

Conjunctivitis itself will not lead to COVID-19 occurring in a person. However, if SARS-CoV-2 causes the condition, then a person may go on to develop COVID-19. While it is an unlikely symptom, it may be worth considering that any signs of conjunctivitis might indicate COVID-19, particularly if a person is also experiencing other more common symptoms of the disease, such as fever, cough, or shortness of breath.

According to the CDC, the more common symptoms of COVID-19 can include:

  • cough
  • fever or chills
  • tiredness
  • shortness of breath or difficulty breathing
  • headache
  • sore throat
  • muscle aches
  • nasal congestion or runny nose
  • vomiting or diarrhea
  • loss of smell or taste

Learn more about the symptoms of COVID-19.

If an individual has eye symptoms and other signs of COVID-19, such as cough and fever, they should contact their doctor. However, eye symptoms alone do not necessarily suggest COVID-19.

If a person is experiencing signs of COVID-19 and begin to show any of the symptoms below, they should seek immediate medical attention:

  • trouble breathing
  • new confusion
  • persistent pressure or pain in the chest
  • inability to awaken or stay awake
  • blue-tinged, pale, or gray skin, nail beds, or lips

People may also consider speaking with their doctor if they experience the following symptoms of pink eye or other signs of an eye emergency:

  • eye pain or trauma
  • redness or discharge in the eye
  • sudden changes in vision
  • sensitivity to light

For people with symptoms of pink eye, the CDC advises treatment with artificial tears and cold compresses. A person who wears contacts should discontinue using them until their symptoms disappear.

Increasing case reports note that conjunctivitis, or pink eye, can occur as a symptom of COVID-19. Pink eye typically presents with redness, swelling, and soreness of the eye, likely because SARS-CoV-2 and other members of the coronavirus family can cause infective conjunctivitis. However, while pink eye and other eye symptoms can occur, they are not common symptoms of COVID-19.

Research indicates that SARS-CoV-2 can enter the eye through exposure to airborne droplets from a cough or touching the eye after touching a contaminated surface.

A person can take measures to try and protect their eyes to reduce the risk of acquiring a SARS-CoV-2 infection. These can include wearing protective eyewear, maintaining physical distance, and not touching the eyes with unwashed hands.