A small outbreak of a rare infection may be linked to the global pandemic of novel coronavirus that marred 2020, according to a case presented to the American Academy of Ophthalmology (AAO) in its annual meeting.

Within a two-month period in 2020, three COVID-19 patients in one health system in New York State developed keratitis, which led to endophthalmitis infection, prompting health experts to theorize about a connection.

Keratitis is an inflammation of the cornea that increases the risk of endophthalmitis. Endophthalmitis infection affects the tissues or fluids in the eye and is extremely rare, occurring in less than 1 percent of eye surgery patients. Symptoms include:

  • Eye pain
  • Redness
  • Blurred vision
  • Swelling of eyelids
  • Eye discharge
  • Decreased or lost vision

Symptoms typically develop within a few days of exposure to the infection, usually from a puncture wound to the eye, surgery, or from an infection elsewhere in the body that spreads to the eye. Left untreated, this type of infection will get progressively worse, possibly leading to blindness.

Endophthalmitis is typically treated with a direct injection of antibiotics to the eye and possibly a corticosteroid to treat swelling. In severe cases, oral antibiotics may be administered to battle the infection.

How might COVID-19 raise infection risks?

During the same observation period, doctors also noted instances of conjunctivitis, or pink eye, in patients battling the novel coronavirus. Although less serious than endophthalmitis, pink eye can also be introduced into the eye through direct contact with contagions such as staphylococcus aureus and streptococcus bacteria.

The correlation between these conditions has prompted some in the medical community to question whether the seepage of air over the top of medical masks could be channeling viruses and bacterium directly into patients’ eyes. More study is needed to determine if this theory is valid.

Will I get an eye infection if I have COVID-19?

To date, no far-reaching studies of the possible link between the coronavirus and eye infection have been conducted, and the data currently available is arguably little more than anecdotal. Of the three New York patients infected with endophthalmitis, one died of COVID-19; a second lost vision in both eyes, while the third lost an eye to infection. All three were in their 60s and had underlying health conditions that may have predisposed them to infection and more serious complications of infection.

In the months since the New York cluster, two other patients in Boston and Australia were reported to have simultaneous COVID-19 and endophthalmitis infections. However, many in the medical community remain unconvinced that these limited case studies represent adequate evidence of a connection. Correlation, we are often told, does not necessarily equal causation.

How can I protect my eyes from infection?

More than any other preventive measure, proper handwashing offers the best defense from COVID-19, plus any secondary infection that could result from it. Contact lens users should practice fastidious lens cleaning and replacement protocols, and both contacts and eyeglasses wearers should avoid touching their faces to prevent virus and bacteria exposure.

Want to reduce your risk of future eye infections? Ask us about permanent vision correction that could get you out of contacts and glasses. Schedule an appointment with an eye doctor at Matossian Eye Associates by calling (800) 708-8800 or booking online at MatossianEye.com.