An ophthalmic insight into novel coronavirus 2019 disease: A comprehensive review of the ocular manifestations and clinical hazards
Amani E Badawi1, Sara S Elsheikh2, Sarah Zaher Addeen3, Mostafa A Soliman4, Rami Abd-Rabu5, Walid Shaban Abdella6, Elham A Gad7
1 Department of Ophthalmology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
2 Faculty of Medicine, Zagazig University, Zagazig, Egypt
3 Department of Ophthalmology, Al Mouassat University Hospital, Damascus University, Damascus, Syria
4 Faculty of Medicine, Cairo University, Cairo, Egypt
5 Evidence Based Practice Center; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
6 Faculty of Medicine, Al Azhar University, Damietta, Egypt
7 Department of Ophthalmology, Faculty of Medicine, Benha University, Banha, Egypt
Amani E Badawi
Department of Ophthalmology, Faculty of Medicine, Mansoura University, 60 Elgomhoria Street, Mansoura
Source of Support: None, Conflict of Interest: None
Purpose: To discuss the ocular manifestations provoked by novel coronavirus 2019 (COVID-19) disease in humans, the natural history of the disease in the eye, and its treatment.
Methods: We designed a narrative review of the ocular manifestations of COVID-19 based on the literature published till July 30, 2020. The databases were PubMed, Scopus, Cochrane Library, Google Scholar, and ScienceDirect. The inclusion criteria were (1) all types of clinical studies and (2) the topic was COVID-19 and its association to the eye regarding the current guidelines.
Results: From 168 abstracts screened, 61 papers fully filled the inclusion criteria after the full-text screening. The 61 records include 13 case reports, 17 prospective (case series or cross-sectional) studies, 8 retrospective studies, 12 literature reviews (one systematic review), and 11 letters to the editor. The majority of the papers agreed that ophthalmic manifestations due to COVID-19 were few and rarely encountered. The main ocular pathology seemed to be conjunctivitis, where the viral polymerase chain reaction also happened to be most detectable. Posterior segment or neuro-ophthalmic manifestations were scarce. Viral genome detection in the eye as well as viral portal of entry to the globe is still vague.
Conclusion: The exact incidence of ocular manifestations in COVID-19 disease is uncertain. Conjunctivitis is the most prevalent ocular manifestation. It is still a debate whether the eye is a portal of entry for infection.