The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a systemic viral infection primarily known for respiratory symptoms like cough and fever. The virus is capable of affecting multiple body systems, including the eyes, which possess the ACE2 receptors the virus uses for cellular entry. Research has documented a link between SARS-CoV-2 infection and various forms of ocular discomfort and other eye-related symptoms. Understanding this connection is important because eye symptoms can sometimes be an early or sole indication of the infection.
Eye Pain and COVID-19
Eye pain, or ocular soreness, is a recognized symptom of COVID-19. This specific symptom has been reported by a measurable percentage of patients, though it is far less common than respiratory or constitutional symptoms like fatigue. In one study, approximately 16% of confirmed COVID-19 patients reported experiencing sore eyes, highlighting it as a significant ocular complaint.
The pain is often described in several ways, including a burning sensation, aching, or generalized soreness of the eye itself. Some patients also report retro-orbital pain, which is an ache or pressure felt specifically behind the eye. While the exact mechanism is still being studied, this pain is thought to be related to the direct effect of the virus on ocular tissues or the systemic inflammation the infection causes throughout the body. Ocular symptoms, including pain, typically appear within two weeks of other, more common COVID-19 indicators and usually resolve within a similar two-week timeframe.
Other Ocular Manifestations
Beyond generalized pain, SARS-CoV-2 infection can lead to other distinct eye issues, the most common being conjunctivitis, often referred to as “pink eye.” Conjunctivitis involves inflammation of the conjunctiva, the thin membrane covering the white part of the eye and the inner surface of the eyelids. Symptoms include redness, excessive tearing, and a watery or mucoid discharge.
The prevalence of any ocular symptom, including conjunctivitis, has been reported to range widely, from around 4% to over 30% in different studies. In some cases, conjunctivitis can be the initial or only manifestation of the COVID-19 infection. Another common complaint is photophobia, which is an uncomfortable sensitivity to light often associated with inflammation caused by the systemic viral infection.
Seeking Medical Attention for Eye Symptoms
Ocular symptoms should be assessed in the context of a suspected or confirmed COVID-19 infection to determine if medical attention is required. Mild viral symptoms, such as slight redness, tearing, or foreign body sensation, can often be managed at home with supportive care. This care may include cool compresses to reduce swelling and irritation or over-the-counter artificial tears to address dryness.
Certain signs warrant an immediate call to a primary care provider or an ophthalmologist, especially if you have a known or suspected COVID-19 infection. These signs include sudden changes in vision, such as blurry vision or vision loss, or the onset of severe, unrelenting eye pain. Double vision, significant swelling, or pain accompanied by a headache, nausea, or vomiting are indicators of potentially serious complications that require prompt professional evaluation. If eye symptoms are present alongside typical COVID-19 indicators like fever, cough, or loss of taste or smell, testing and isolation protocols should be followed.