With healthcare information changing daily amidst the COVID-19 pandemic, little attention has been given to its effect on one of the most sensitive parts of our bodies: the eyes. American Academy of Ophthalmology gives insight to commonly asked questions and reviewed research on the effect of SARS-CoV-2 and our eyes.

If COVID-19 droplets land in your eye, are you susceptible to infection?

Mucous membranes, which line many body cavities and organs including the respiratory tract, are most susceptible to this novel coronavirus and viruses in general. The mode of COVID-19 transmission is believed to be through respiratory droplets from person-to-person, primarily. However, if infected droplets land in your eye, you are susceptible to the infection. Additionally, the virus can also live on surfaces up to a few days, therefore touching an infected surface, then touching your eyes, nose or mouth without washing your hands will lead to infection.

How can the coronavirus affect your eyes?

The coronavirus can spread through the eyes, just as it does through the mouth or nose. When someone who has coronavirus coughs, sneezes or talks, virus particles can spray from their mouth or nose onto your face. You are likely to breathe these tiny droplets in through your mouth or nose. But the droplets can also enter your body through your mucosal membranes of the eyes, called the conjunctiva.

Is it true that pink eye is an early sign of COVID-19?

Yes, pink eye, or conjunctivitis, has been reported to be a possible sign of infection from COVID-19. It is still uncertain exactly what percentage of patients with COVID-19 has ocular manifestations and different sources are reporting different numbers.

Keep in mind that whether pink eye is caused by a virus or bacteria, it can spread if someone touches that sticky or runny discharge from the eyes, or touches objects contaminated by the discharge. Wash and sanitise your hands frequently, and do not share towels, cups or utensils with others.

A recent study in JAMA Ophthalmology reported up to one-third of patients hospitalised with COVID-19 had ocular abnormalities, however more studies are still needed.

Should I worry about my itchy, watery eyes?

If they are red, watery and itchy, these are probably signs of allergies. Coronavirus symptoms generally do not cause those uncomfortable itchy, watery eyes. Another key difference between seasonal allergy symptoms and coronavirus symptoms is having a fever. Allergy sufferers do not have fever as a symptom, while coronavirus patients often do.

How can you protect your eyes and health during COVID-19?

According to ophthalmologist Sonal Tuli, MD, a spokesperson for the American Academy of Ophthalmology, “It’s important to remember that although there is a lot of concern about coronavirus, common sense precautions can significantly reduce your risk of getting infected. So wash your hands a lot, follow good contact lens hygiene and avoid touching or rubbing your nose, mouth and especially your eyes,”

Guarding your eyes, as well as your hands, nose, and mouth, can slow the spread of coronavirus. Here are some ways you can keep your eyes safe and healthy during this coronavirus outbreak:

1. If you wear contact lenses, consider switching to glasses for a while.

There is no evidence that wearing contact lenses increases your risk of coronavirus infection but contact lens wearers touch their eyes more than the average person, Dr Tuli points out. “Consider wearing glasses more often, especially if you tend to touch your eyes a lot when your contacts are in. Substituting glasses for lenses can decrease irritation and force you to pause before touching your eye,” she advises.

2. Wearing glasses may add a layer of protection.

Corrective lenses or sunglasses can shield your eyes from infected respiratory droplets but keep in mind that they do not provide 100% security. The virus can still reach your eyes from the exposed sides, tops and bottoms of your glasses. If you are caring for a sick patient or potentially exposed person, safety goggles may offer a stronger defense.

3. Stock up on eye medicine prescriptions if you can.

Experts advise patients to stock up on critical medications, so that you will have enough to get by if you are quarantined or if supplies become limited during an outbreak. This may not be possible for everyone. If you can obtain more than one month of essential eye medicine, such as glaucoma drops, you should do so. Do not wait until the last minute to contact your pharmacy.

4. Avoid rubbing your eyes.

It can be hard to break this natural habit, but doing so will lower your risk of infection. If you feel an urge to itch or rub your eye or even to adjust your glasses, use a tissue instead of your fingers. Dry eyes can lead to more rubbing, so consider adding moisturising drops to your eye routine. If you must touch your eyes for any reason — even to administer eye medicine — wash your hands first with soap and water for at least 20 seconds. Then wash them again after touching your eyes.

5. Practice safe hygiene and social distancing.

Wash your hands a lot. Follow good contact lens hygiene and avoid touching or rubbing your nose, mouth and eyes.

If you have any questions about your eyes or your vision, be sure to ask your ophthalmologist.

New procedures for routine and urgent eye care during COVID-19

• You should wear a mask to your appointment.

• The clinic may ask you to wait outside, or in your car, instead of in the normal waiting room. This is to protect you, the other patients, and the office staff from possible virus exposure in crowded waiting areas.

• Your temperature may be checked on entry to the building.

• Your eye doctor may use a special plastic breath shield on the slit lamp machine they use to look into your eyes. They will also wear a mask, and may also wear gloves, goggles, or a plastic shield over their eyes.

• Your doctor may ask you to wait to speak until after your eye exam is complete. Then they can talk with you and answer questions when they can be a safe distance from you.

If you are visiting your ophthalmologist’s office for routine eye care or for an urgent need, you may feel nervous about venturing out during the COVID-19 Pandemic. Rest assured that ophthalmologists, like all medical professionals, follow strict hygiene and disinfection guidelines.