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We all have been fighting COVID 19 disease since December 2019 it has become a global pandemic caused by the highly transmissible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Eyes can be affected in various stages of disease . We should be aware of certain signs and symptoms because most of these eye related problems can be treated and controlled.
Common eye related problems are
Red eyes/ Sore eyes
Retina related eye problems
Optic nerve related and other eye nerve related problems
Post COVID Mucor or Black fungus related problems.
Sore eyes : This condition is called conjunctivitis
Initially, there were several reports of eye redness and irritation in COVID-19 patients, both anecdotal and published, suggesting that conjunctivitis is an ocular manifestation of SARS-CoV-2 infection.
As conjunctivitis is a common eye condition, ophthalmologists may be the first medical professionals to evaluate a patient with COVID-19. Indeed, one of the first providers to voice concerns regarding the spread of coronavirus in Chinese patients was Dr. Li Wenliang, MD, an ophthalmologist. He later died from COVID-19 and was believed to have contracted the virus from an asymptomatic patient in his clinic.
This disease presents mainly with Red eyes watery or sticky discharge. This is mostly self limiting disease needs only symptomatic treatment. This can be in early stage of the disease.
Retina related problems :
Retina is a thin sheet of light sensitive tissue which is responsible for vision in the eye. Problems in the retina can lead to vision loss and even blindness. Covid 19 can affect our retina by 2 ways , one by causing clots in retinal blood vessels and other by causing swelling in the retina. This usually occurs in 4 to 6 weeks following Covid 19 infection.
So, patients who have recovered from COVID and had been treated with steroids should watch out for such symptoms for the initial weeks or till the time they are on steroids for lung complications. The most common symptom is blurring of vision (not necessarily accompanied by redness or pain). But the good news is that, so far, based on the cases reported to us, the risk to develop this condition is less than 1%, and this can be treated effectively with some injections and medicines. If ignored can cause severe vision loss.
Optic nerve and other eye nerve problems:
Optic nerve is the main nerve of the eye which connects eye to the brain and caries all visual signals. Covid 19 can affect this nerve causing blurred vision and pain in the eye . The condition is called Optic neuritis. this can occur anytime post recovery between 4 to 6 weeks .This particular problem also can be treated effectively if diagnosed early.
Other eye nerves which control eye movements are also involved sometimes causing double vision and lack of eye movements due to paralysis of these nerves.
Post COVID Mucormycosis or Black Fungus related eye problems :
Mucormycosis, a potentially life-threatening fungal infection, is adding to India’s COVID-19-related death toll.
This has been in news for a while now and is emerging as a new burden on healthcare system which is already under stress
It typically affects patients recovering from COVID-19 who are suffering with low immunity due to COVID or by the use of steroids and/or concomitant diabetes.
Common symptoms of mucormycosis that an eye doctor can easily detect are eyelid edema, orbital pain, eyelid ptosis, protruding eyes, ocular motility restrictions, double vision and sudden vision loss. They may be preceded by or associated with other symptoms, such as dental pain, stuffy nose, poor smell, nasal discharge and bleeding, facial paresthesia and palsy.
Post-COVID patients who are treated with steroids and patients with diabetes should be even more careful. The combination of COVID-19, corticosteroid therapy and diabetes creates the perfect storm in which mucormycosis takes roots and thrives.
Corticosteroids are a life-saving treatment used to reduce the dysregulated immune response observed in patients with COVID-19. However, they increase the blood sugar level, and fungi enjoy the sugar and this creates an even more favorable environment for the fungus to grow. The infection can reach the brain very soon and can cause serious life threatening problems.
This disease if detected early can be treated by team of Doctors involving ENT, OPHTHALMOLOGIST, NEUROSURGEON AND DENTAL SURGEON.
Remember few points about Black fungus
1. Occurs in Covid-19 recovery patients who are diabetic and are treated with steroids
2. Its does not spread form one person to another
3. Does not occur in patients with good immunity
4. Can be treated when detected early , so high index of suspicion and awareness required
DR SACHIN MAHULI
DIRECTOR ,
NETRADARSHAN SUPER SPECIALTY EYE HOSPITAL
BELGAUM
28/06/2021
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