Children’s eyes may be negatively impacted by COVID-19 infection, a new study has revealed.
Findings from the study, published in the peer-reviewed journal, JAMA Ophthalmology, revealed that some children after recovering from the COVID-19 have eye pain or eyelid swelling, while others experience epiphora or tearing, a condition in which there is an overflow of tears.
Before now, the National Health Service had highlighted that the major signs of the virus to be fever, cough, and loss of taste or smell.
However, the World Health Organisation has described the NHS list as too limited, noting that everything from diarrhoea to discolouration of the toes (COVID toes) could indicate infection.
Last year, the public questioned the claim that a patient’s eyesight could be affected by COVID-19, after Boris Johnson’s chief adviser, Dominic Cummings, defended driving 260 miles from London to his parent’s farm in Durham, during the lockdown to test his vision. He claimed his vision was affected by the virus.
However, findings from the recent study suggest there could be a link.
Reacting to the study, a Consultant Ophthalmologist at the Lagos State University Teaching Hospital, Lagos, Dr. Bolanle Balogun, said children who succumb to COVID-19 might have underlying medical conditions or reduced immunity.
Speaking exclusively with PUNCH Healthwise, she noted that children have not been as affected by COVID-19 as adults, adding that it goes to show that their immunity to the virus is better and stronger.
“Majority of children and young adults have good immunity that is why they have not been symptomatic,” she added.
The eye specialist noted that aside from blood clotting and other symptoms associated with COVID-19, there have been complaints about red eyes. She, however, said that the inclusion of children is a recent development.
Dr. Balogun explained that the eyes, nose and mouth are interconnected.
She noted that there is what is known as the nasolacrimal drainage system that serves as a conduit for tear flow from the external eye to the nasal cavity and that the connection can make the infection spread both ways.
“There is a small hole by the inner angle of the eyelid, towards the nose side of the eyelid, through which tears produced can drain into the nose.
“The small opening can be clearly seen with pen touch.
“That is why sometimes when an individual has a catarrh, the eye becomes red and watery. Infection can move from the eyes to the nose, and to the respiratory tract. That is the connection,” the eye expert said.
According to the research, after looking at 216 youngsters admitted to Wuhan Children’s Hospital in China with the infection, medical experts found more than one in five (22.7%) experienced conjunctivitis (pink eye) or “eye rubbing”.
They also looked at children, with an average age of seven, who were admitted to hospital with confirmed COVID-19 infection between January 26 and March 18, 2020.
The researchers noted that “Two in five (43.1%) of the children showed no sign of an infection.
“The reason they were tested for the coronavirus is unclear, but they may have been swabbed after a relative tested positive or if they were in the hospital for another reason.
“Among those showing symptoms, more than a third developed a fever (37.5%) or cough (36.6%).
“Perhaps surprisingly, 49 of the youngsters (22.7%) showed various eye symptoms, which were the first sign of infection in nine of the patients.
“Of the 49 children, more than half (55.1%) experienced conjunctival discharge, which can include the release of white mucus or yellow-green pus.”
According to Mayo Clinic, Conjunctivitis is the inflammation or infection of the transparent membrane that lines the eyelid and covers the white part of the eyeball.
It explained that when small blood vessels in the conjunctiva become inflamed, they are more visible.
“This is what causes the whites of your eyes to appear reddish or pink,” it added.
The online health portal further explained that pink eyes are commonly caused by a bacterial or viral infection, an allergic reaction, or in babies, an incompletely opened tear duct.
“Though pink eyes can be irritating, it rarely affects your vision. “Treatments can help ease the discomfort of pink eyes.
“Because pink eyes can be contagious, early diagnosis and treatment can help limit its spread,” it stated.
Further findings from the study revealed that eye rubbing affected more than a third (38.8%), while one in 10 (10.2%) had conjunctival congestion; generally a feeling of grittiness or producing pus that sticks to the eyelashes.
The results further revealed four (8.2%) of the children experienced eye pain or eyelid swelling, while two (4.1%) were tearing.
Twenty-three of the patients recovered without treatment, while the remaining were given drops.
Also, while eight of the children continued to rub their eyes as the study drew to a close, the other 41 were completely better after about a week.
Although it remains unclear how the symptoms may have come about, the scientists, however, explained that the eye surface “communicates with air” in the same way as the nasal passage, which is the main route of infection.
“Ducts that link the eye to the nose may also provide the opportunity for the viruses to travel from the respiratory tract to the ocular surfaces”, they added.
They also noted that COVID-19 could also directly affect the eyes, with its tissues expressing the enzyme used by the pathogen to enter cells.
“Infected children may also rub a contaminated hand against their eye, or the force of a cough or sneeze could “push nasopharyngeal secretions” up their face,” they added.
The authors of the study, however, said further research is required.
Before now, the WHO had listed conjunctivitis as a “less common” coronavirus symptom.
The US Centres for Disease Control and Prevention listed 11 potential signs of infection, ranging from shortness of breath to headaches, but nothing eye-related was highlighted.
Based on data so far, doctors believe that one to three per cent of people with COVID-19 will get conjunctivitis, also called pinkeye.
They explained that it happens when the virus infects a tissue called the conjunctiva, which covers the white part of your eye or the inside of the eyelids.
According to a report published on March 25, 2020, in Today.com, before now, pink eyes have always been identified with adults.
The report noted that the discovery that COVID-19 can spread through the eyes, prompted the American Academy of Ophthalmology, to urge its members to be aware of the warning signs in patients.
The association further advised eye doctors to be on the lookout for patients who complained of pink eyes — with symptoms including redness, swelling and sometimes a sticky discharge in one or both eyes — and who also had a fever and respiratory symptoms such as cough and shortness of breath.
On how to care for conjunctivitis, Dr. Balogun noted that usually, treatment is not needed, because the symptoms often clear up within a couple of weeks.
She said in severe cases, antibiotic eye drops can be used to clear the infection.
“Irritant conjunctivitis will clear up as soon as whatever is causing it is removed,” she added.
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