Abstract
Since the beginning of 2020, SARS-CoV-2, the pathogen of COVID-19, has led to a global
pandemic that also affects ophthalmology. Ophthalmologists can be confronted at any
time with potentially COVID-19 associated ocular symptoms or manifestations in patients
and also become infected through close patient contact. Even without systemic infection,
the ocular surface can come into direct contact with aerosols or liquids containing
SARS-CoV-2 particles. A smear infection through hand-to-eye contact is also possible.
A purely isolated ocular infection has not yet been shown. Rather, it seems that ocular
complications occur in the context of a systemic infection. However, ocular symptoms
can also be the first symptom of COVID-19. The most common ocular complication of
COVID-19 is mild follicular conjunctivitis. Haemorrhagic conjunctivitis, dry eye disease,
episcleritis, or retinal involvement can also occur less frequently. There are currently
no evidence-based therapy
recommendations for COVID-19 associated diseases of the ocular surface. Artificial
tears might be helpful for symptom relief. There is no evidence for antiviral, antibiotic,
or anti-inflammatory therapies, but these medications might be used in individual
cases. Potential intraocular complications include retinal artery occlusions and haemorrhages,
as well as cotton wool spots caused by complement-mediated thrombotic angiopathy.
Neuro-ophthalmological complications including Miller-Fisher syndrome or infarct-related
central blindness can also occur in very rare cases. Knowledge of potential transmission
routes and personal protective equipment is just as essential for each ophthalmologist
as a basic knowledge of potential ocular symptoms and complications.
Key words
transmission - pandemic - conjunctivitis - SARS-CoV-2 - COVID-19
