With the coronavirus pandemic dominating our news these days, there has been some talk that conjunctivitis might be one of the symptoms of COVID-19. It is important to understand that the virus can be transmitted by touching an infected surface and then touching the eyes leading to infection.
Conjunctivitis occurs when the transparent membrane, the conjunctiva, that lines the eyelid and the white of your eye becomes inflamed or infected. This condition is most often caused by a bacterial or viral infection but may also be related to allergies. The commonality of conjunctivitis has led to the argument of whether it is a symptom of COVID-19 or another unrelated infection all together. The important finding concerning COVID-19 is that patients can be asymptomatic and still transmit the virus, and therefore conjunctivitis could be an early sign of infection.
The discussion may seem inconsequential except that if a patient is otherwise not showing signs of infection such as fever or cough, but the patient has ocular symptoms of conjunctivitis, the patient could indeed spread the virus. An example of how this might happen could be a person with viral conjunctivitis rubbing or scratching an already irritated and inflamed eye and then touching a door handle, a shopping cart, or a retail item that is then handled by a cashier or a bagger. Another person, possibly the cashier or bagger, touches the area previously infected and then proceeds to touch their face or eyes leading to infection. Therefore, it is highly important to sterilize any surface such as shopping carts or gas pumps which have been touched by several people throughout the day, wash your hands regularly with hand sanitizer or soap if available, and avoid contact with your face, eyes, nose, and mouth.
Though the American Academy of Ophthalmology has indicated that conjunctivitis remains an “uncommon” condition as it relates to COVID-19, they have suggested that the possibility exists that a patient with COVID-19 associated conjunctivitis could have the infectious virus in their tears. The important lesson to learn here is that SARS-CoV-2, the virus that causes COVID-19 is an adaptive infection with a higher infection rate than influenza. An epidemiological study conducted at the Los Alamos National Laboratory in February found that this coronavirus could be more than twice as infectious as the flu.
Whether or not conjunctivitis is one of the methods this virus has adopted to propagate itself, it is appropriate to alter our outdated assumptions about who may be considered infectious. Gone are the days when we assumed that a person had to have a fever to be considered contagious. We now know that people can be asymptomatic and pass this infection on to others. With this knowledge, it is more important than ever that we continue to take extra precautions to protect ourselves and others as we emerge from this crisis and begin to return to normal life.