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Severe COVID-19 patients may suffer eye abnormalities that might go unnoticed in hospitals

Conjunctivitis or pink eye is also seen as uncommon symptoms of COVID-19.

Eye screening should be considered for all patients with severe COVID-19, suggested researchers after they spotted severe eye abnormalities in some patients hospitalized in the ICU. They have also revealed the possible causes of the problems.

Written by Longjam Dineshwori |Updated : February 18, 2021 10:59 AM IST

It is known that the novel coronavirus primarily attacks the lungs in the affected individuals, and sometimes leads to life-threatening Acute respiratory distress syndrome (ARDS) and pneumonia in some people with severe Covid-19. But the virus can affect multiple organs in the body, especially in critically ill patients. Doctors around the world have detected damage in the kidneys, heart, brain and other organs associated with the viral infection. According to an article published in Frontiers in Medicine or Front Med (Lausanne), multiple-organ failure due to hyperactivity of the immune system (cytokine storm) is that main cause of death among the 5 percent critically ill COVID-19 patients. Medical professionals have also found significant abnormalities in the eyes of some people with severe COVID-19 that are likely to go unnoticed during the treatment in hospitals.

Thus, eye screening is important for hospitalised coronavirus patients to provide appropriate treatment and management of potentially severe ophthalmological manifestations of COVID-19, suggested to a study published in the journal Radiology.

Eye abnormalities linked withCOVID-19

Conjunctivitis or pink eye, and retinopathy, a disease of the retina that can result in vision loss, are also seen as uncommon symptoms of COVID-19. But researchers have also spotted eye abnormalities visible only on MRI exams. To better understand the nature and frequency of these unusual eye abnormalities, the French Society of Neuroradiology (SFNR) studied the MRI scans of 129 patients with severe COVID-19. They found abnormalities in the globe, or eyeball, in nine of these patients. Their MRI scans showed one or more nodules in the back part, or posterior pole, of the eyeball. Eight of them were treated in the intensive care unit (ICU) for COVID-19.

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All nine patients had nodules in the macular region, the area in the back of the eye responsible for our central vision, and eight of them had nodules in both eyes said the researchers.

Doctors should consider eye screening using high-resolution MRI for all patients with severe COVID-19 to detect these nodules, the researchers said.

They also recommended conducting additional exams like fundoscopy, which uses a magnifying lens and a light to check the back of the inside of the eye, and optical coherence tomography, a non-invasive test that provides a 3D picture of the structure of the eye.

Cause of eye abnormalities in severe COVID-19 patients

While the researchers are still unclear about the actual cause of nodule formation in severe COVID-19 patients, they suspect that it could be due to inflammation triggered by the virus. Another possible factor, according to them, may be the inadequate drainage of the veins of the eyes, a problem seen in patients hospitalized in the ICU who are placed in the prone position or intubated. Seven of the patients with severe eye abnormalities in the study spend time in the ICU in the prone position for an extended period.

Lead author Augustin Lecler, M.D., Ph.D., associate professor at the University of Paris and neuroradiologist from the Department of Neuroradiology at the Foundation Adolphe de Rothschild Hospital in Paris, noted that such eye abnormalities might largely go unnoticed in the clinic, as treatment of hospitalized COVID-19 patients usually focuses more on other severe, life-threatening conditions.

The researchers are monitoring the identified nodules in these patients to see if they lead to any clinical consequences such as vision loss or visual field impairment.

While two of the nine patients with eye nodules, had diabetes, six were obese and two had hypertension. Thus, the study also supports previous research that showed people with existing health problems are at higher risk of severe COVID-19 infection and long-term complications.

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