ABSTRACT
COVID-19 (Corona Virus Diseases-2019) is the newest global pandemic caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2). This article aims to study the relationship between COVID-19 and the conjunctival swab test systemically. This article is based on several scientific reports related to conjunctival swab performed in COVID-19 patients from the PUBMED database, Google Scholar, Springer Link, Elsevier, medRxiv, bioRxiv, and Wiley Online Library. Keywords used are conjunctivitis, ocular, ophthalmic, COVID-19, SARS-CoV-2, 2019-nCoV, Coronavirus, Coronavirus-19, Coronavirus19, pathophysiology, mechanisms, tear, conjunctival swab, RT-PCR, and conjunctiva. Eight reports were reviewed in this article. Respiratory symptoms and ocular manifestation such as conjunctivitis with hyperemic eyes, conjunctival chemosis, epiphora, and other rare ocular manifestations were observed in COVID-19 patients. Ocular manifestation may present as a sole symptom, prodromal symptom, simultaneously appear with the systemic symptom, or as residual floaters. Various therapy was given according to the complaints. RT-PCR results from the conjunctival swab test may be positive and negative in COVID-19 patients with conjunctivitis. From this article, we hope to highlight the importance to take optimal prevention measures for medical staff despite the presence or absence of ocular clinical manifestation.
ABSTRACT
Purpose: To report endogenous fungal endophthalmitis, postrecovery from severe COVID-19 infection in otherwise immunocompetent individuals, treated with prolonged systemic steroids. Methods: Retrospective chart review of cases with confirmed and presumed fungal endogenous endophthalmitis, following severe COVID-19 disease, treated at two tertiary care referral eye institutes in North India. Results: Seven eyes of five cases of endogenous fungal endophthalmitis were studied. All cases had been hospitalized for severe COVID-19 pneumonia and had received systemic steroid therapy for an average duration of 42 ± 25.1 days (range 18-80 days). All the cases initially complained of floaters with blurred vision after an average of 6 days (range 1-14 days) following discharge from hospital. They had all been misdiagnosed as noninfectious uveitis by their primary ophthalmologists. All eyes underwent pars plana vitrectomy (PPV) with intravitreal antifungal therapy. Five of the seven eyes grew fungus as the causative organism (Candida sp. in four eyes, Aspergillus sp. in one eye). Postoperatively, all eyes showed control of the infection with a marked reduction in vitreous exudates and improvement in vision. Conclusion: Floaters and blurred vision developed in patients after they recovered from severe COVID-19 infection. They had received prolonged corticosteroid treatment for COVID-19 as well as for suspected noninfectious uveitis. We diagnosed and treated them for endogenous fungal endophthalmitis. All eyes showed anatomical and functional improvement after PPV with antifungal therapy. It is important for ophthalmologists and physicians to be aware of this as prompt treatment could control the infection and salvage vision.