The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, is primarily known as a respiratory pathogen. However, the illness is systemic, affecting multiple organ systems throughout the body. Reports surfaced suggesting the virus could also manifest with symptoms affecting the eyes, leading to questions about whether itchy eyes could indicate a COVID-19 infection.
The Direct Answer: Eye Symptoms and COVID-19
Itchy eyes can be a symptom of COVID-19, though it is not considered a primary or defining feature of the infection. The itchiness is most often related to the development of viral conjunctivitis, commonly known as pink eye, which the virus can trigger. Studies estimate that overall ocular symptoms, including itchiness, affect about one in ten people diagnosed with COVID-19. When itchiness is reported, it is usually mild and occurs alongside other, more prevalent symptoms of the disease, such as fever, cough, and fatigue. Isolated itchy eyes without other systemic indicators are not typically the first sign a person has contracted SARS-CoV-2.
Understanding Ocular Manifestations of SARS-CoV-2
The reason SARS-CoV-2 can affect the eyes lies in the presence of the Angiotensin-Converting Enzyme 2 (ACE2) receptor on the ocular surface. This receptor, which the virus uses as an entry point into host cells, is expressed in the epithelial cells of the conjunctiva, cornea, and limbus. This allows the virus to directly infect the eye tissue, leading to inflammation.
The most frequent eye condition linked to the infection is viral conjunctivitis. This inflammation of the clear membrane lining the eyelid and eyeball often presents with redness, a watery discharge, and a gritty sensation, in addition to the possible itchiness. Other reported symptoms include photophobia, or light sensitivity, and a general feeling of soreness in the eyes.
While conjunctivitis is the most common manifestation, other, more serious conditions have been reported in some patients, though they are rare. These can include neuro-ophthalmic issues and retinal complications, which are thought to be related to systemic inflammation and blood clotting effects of the virus. The onset of eye symptoms typically occurs within two weeks of other respiratory symptoms and usually resolves relatively quickly.
Common Causes of Itchy Eyes
Since isolated itchy eyes are an infrequent sign of COVID-19, the cause is usually far more common environmental or chronic issues. Seasonal allergies are the most frequent culprit, resulting from the body’s immune response to airborne irritants like pollen, pet dander, or mold. This allergic reaction releases histamine, which causes inflammation, redness, and intense itching.
Another significant cause is Dry Eye Syndrome, a chronic condition where the eyes do not produce enough quality tears to stay adequately lubricated. This can lead to a scratchy or gritty feeling, burning, and sometimes an uncomfortable itchiness as the ocular surface becomes irritated. Environmental factors, such as staring at screens for extended periods, exposure to wind, or simply aging, can exacerbate these symptoms.
Irritation from contact lenses is another frequent trigger for eye itchiness. Improper lens hygiene, wearing lenses for too long, or sensitivity to cleaning solutions can all lead to discomfort and itching. Furthermore, exposure to environmental irritants like smoke, dust, or certain chemicals can cause a temporary but noticeable reaction that mimics the viral or allergic symptoms.
Next Steps and When to Seek Medical Guidance
If you experience itchy eyes, the first step is to assess for the presence of other systemic symptoms. If the eye itchiness is accompanied by classic COVID-19 signs, such as fever, persistent cough, fatigue, or loss of taste or smell, you should follow current public health recommendations regarding testing and isolation. In the absence of these systemic symptoms, treating the issue as a routine allergy or irritation is generally appropriate.
For mild, isolated itchiness, home care can provide relief, often involving artificial tears to lubricate the eyes and applying a cool compress to reduce inflammation. Avoid touching or rubbing the eyes, as this can worsen irritation and potentially spread infection. If you wear contact lenses, switch to glasses until the symptoms resolve completely.
You should seek medical consultation if the itchiness is severe, does not improve with home care after a few days, or if you develop concerning symptoms. Urgent evaluation by an eye care professional is needed for significant eye pain, sudden changes in vision (such as blurriness or loss of sight), or excessive discharge. These symptoms may indicate a more serious complication that requires immediate treatment.