Review Article
Volume 12 Issue 11 - 2021
Ocular Implications in COVID Era: A Challenge
Anuradha Raj1* and Nikhil Agrawal2
1Associate Professor, Department of Ophthalmology, All India Institute of Medical Sciences, Bathinda, Punjab, India
2Assistant Professor, Department of Ophthalmology, All India Institute of Medical Sciences, Bathinda, Punjab, India
*Corresponding Author: Anuradha Raj, Associate Professor, Department of Ophthalmology, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Received: May 28, 2021; Published: October 29, 2021


Coronavirus disease 2019 (COVID-19) is an ongoing pandemic, and this virus spreads mainly during close contact by tiny droplets. Ocular surfaces being a potential mode for the transmission, ophthalmologists are highly prone to acquire this infection. Due to the presence of angiotensin-converting enzyme 2 in various ocular tissues and cytokine storm lead to vasoconstriction, ischemia, hypercoagulopathy and thromboembolic phenomenon, this virus binds easily and shows various ocular manifestations such as conjunctivitis, retinal vascular occlusions, worsening of diabetic retinopathy, ocular nerve palsies and orbital mucormycosis. Proper ocular care and awareness among the medical fraternity need the hour for prompt diagnosis and management to avoid irreversible sight loss.

Keywords: Coronavirus Disease 2019; Central Retinal Artery Occlusion; Hyper-Coagulopathy Mucormycosis


  1. World Health Organization. Pneumonia of unknown cause- China (2020).
  2. Huang C., et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China”. Lancet 395 (2020): 497-506.
  3. Cucinotta D., et al. “WHO declares COVID‑19 a pandemic”. Acta Biomedica 91 (2020): 157-160.
  4. Rothan HA., et al. “The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak”. Journal of Autoimmunity 109 (2020): 102433.
  5. Wan Y., et al. “Receptor recognition by novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS”. Journal of Virology 94 (2020): e00127-20.
  6. Yan Sun LL., et al. “Mechanism of the action between the SARS-CoV S240 protein and the ACE2 receptor in eyes”. Journal of Virology 6 (2006): 783-786.
  7. Senanayake PS., et al. “Angiotensin II and its receptor subtypes in the human retina”. Investigative Ophthalmology and Visual Science 48 (2007): 3301-3311.
  8. Wagner J., et al. “Demonstration of renin mRNA, angiotensinogen mRNA, and angiotensin converting enzyme mRNA expression in the human eye: evidence for an intraocular renin-angiotensin system”. British Journal of Ophthalmology 80 (1996): 159-163.
  9. Romano MR., et al. “Facing COVID-19 in ophthalmology department”. Current Eye Research 45 (2020): 653-658.
  10. EK Mela., et al. “Ocular surface bacterial colonisation in sedated intensive care unit patients”. Anaesthesia and Intensive Care (2010): 190-193.
  11. P Ghelichkhani., et al. “Prone position in management of COVID-19 patients; a commentary”. Archives of Academic Emergency Medicine 8 (2020): e48.
  12. M Dinkin., et al. “COVID-19 presenting with ophthalmoparesis from cranial nerve palsy”. Neurology (2020): 221-223.
  13. MA Cheng., et al. “The effect of prone positioning on intraocular pressure in anesthetized patients”. Anesthesiology (2001): 1351-1355.
  14. Greven CM., et al. “Retinal arterial occlusions in young adults”. American Journal of Ophthalmology 120 (1995): 776 783.
  15. Raj A., et al. “Cavernous sinus thrombosis with central retinal artey occlusion in COVID-19: A case report and review of literature”. Indian Journal of Ophthalmology 69 (2021): 1327-1329.
  16. Raval N., et al. “Central retinal vein occlusion in the setting of COVID-19 infection”. The Journal of Ophthalmic Inflammation and Infection 11 (2021): 10.
  17. Lai THT., et al. “Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: an experience from Hong Kong”. Graefe's Archive for Clinical and Experimental Ophthalmology (2020): 1-7.
  18. Medicare expands telemedicine during pandemic.
  19. American Academy of Ophthalmology. Alert: important coronavirus updates for ophthalmologists.
  20. Zhou Y., et al. “Ophthalmologic evidence against the interpersonal transmission of 2019 novel coronavirus through conjunctiva”. Med Rxiv (2020).
  21. Sadda SR., et al. “Impact of scanning density on measurements from spectral domain optical coherence tomography”. Investigative Ophthalmology and Visual Science 51 (2010): 1071-1078.
  22. Mossa-Basha M., et al. “Radiology Department Preparedness for COVID-19: Radiology Scientific Expert Panel”. Radiology (2020): 200988.
  23. American Academy of Ophthalmology. Important Coronavirus Updates for Ophthalmologists”. American Academy of Ophthalmology (2020).
  24. COVID-19: resources for households (2020).
  25. Li HK. “Telemedicine and ophthalmology”. Survey of Ophthalmology 44 (1999): 61-72.
  26. Raj A. “Tele Ophthalmology for Various Ocular Sub-specialities during Novel Coronavirus Disease 2019 Pandemic in Indian Scenario”. EC Ophthalmology4 (2021): 59-65.
  27. Sen M., et al. “Mucor in a viral land: A tale of two pathogens”. Indian Journal of Ophthalmology 69 (2021): 244-252.
  28. Sarkar S., et al. “COVID-19 and orbital mucormycosis”. Indian Journal of Ophthalmology 69 (2021): 1002-1004.
  29. Skied A., et al. “Epidemiology and diagnosis of mucormycosis: An update”. Journal of Fungi 6 (2020): 265.
  30. Sen M., et al. “COVID-19 and eye: A review of ophthalmic manifestations of COVID-19”. Indian Journal of Ophthalmology 69 (2021): 488-509.
  31. Dannaoui E., et al. “Global guideline for the diagnosis and management of mucormycosis: An initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium”. The Lancet Infectious Diseases 19 (2019): e405-421.
Citation: Anuradha Raj and Nikhil Agrawal. “Ocular Implications in COVID Era: A Challenge”. EC Ophthalmology 12.11 (2021): 51-57.

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