The CDC warns everyone to take precautions out in public, even advising against touching the skin around the eyes, but we could be far less protected than we think. New evidence is emerging on the level of eye involvement researchers are seeing in COVID-19 patients. The implications of this could be huge, especially when it comes to how we approach safety outside the home.
Precautions aren't preventions. Even with their strict use, we are still vulnerable to COVID-19. But as we learn more we hope to be better able to protect ourselves and everyone else. New research is revealing that eyes may be susceptible pathways of infection. Not only that, but the coronavirus may also attack the eyes themselves, causing conjunctivitis and other symptoms.
The conjunctiva, or the very outer layer of the eyes, is a mucus membrane. This membrane lines the interior of the eyelids and parts of the whites, helping to keep the exterior of the eyes themselves lubricated and serving as the first line of defense against invading pathogens. But it’s by no means a perfect blockade. Those who have ever had conjunctivitis know all too well how vulnerable the eyes can be to infection.
It just so happens that the conjunctiva is covered in a type of receptor that SARS-CoV-2, the coronavirus responsible for COVID-19, uses to sneak into the body. This receptor, ACE2, along with the presence of an enzyme called TMPRSS2, makes it even easier for the virus to take hold in the eyes. This means it’s possible to catch COVID-19 by touching the eyes after touching a contaminated surface.
It could also mean that an individual could become infected if the aerosolized virus lands on the surface of the eye. So, in theory, it’s possible to catch the virus just by walking where an infected person recently coughed or breathed, even when wearing a face mask. (Remember, we wear masks to protect others from this and other means of infection, not ourselves.)
Studies have determined that many COVID-19 patients are showing symptoms of conjunctivitis, or “pink eye.” These ocular manifestations, irritated, watery, congested eyes, appear to be more common in severe cases. This seems to coincide with differences in blood work, as well. People with eye involvement are also more likely to have elevated white blood cell counts and higher inflammatory markers.
Because it’s not bad enough that the eyes are easy entry and infection points for SARS-CoV-2, it’s no surprise that they may also be a means of disease transmission. Yep, it looks like it might go both ways. In one study, COVID-19 was detectable in eye secretions long after the virus stopped showing up on nasal swabs.
Other studies have found evidence that the virus can sometimes find its way into a person’s tears. This does, however, appear to be rare. Studies are still lacking on whether this means an infected person’s eye secretions can transmit the disease to others, but it does seem likely that they could pose a danger in some cases.
There’s really no saying how safe anyone can be out there as long as sick people and asymptomatic super-spreaders continue to go out alongside us, especially when some of them aren’t wearing masks. The best any of us can do right now is continue to follow the CDC’s recommendations when going out. This includes avoiding close contact with other people, wearing a cloth mask and regularly using soap and water or a hand sanitizer that contains at least 60% alcohol. Avoid crowded places where you can't stay at least 6 get from others, and avoid touching your face. Your safety might not be guaranteed, but at least you’re playing the better odds and taking steps to protect others from you in case you are a carrier.
COVID-19 has proven itself a force to be reckoned with, and its effects on the eyes are just one more low blow. There’s still a lot we don’t know about this illness. All anyone can say with any certainty is that this probably isn’t the last surprise the virus has in store for us. Stay safe out there.
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