COVID-19 eye infection: recommendations for ophthalmologist and patients

Datu Respatika(1*), Indra Tri Mahayana(2), Dwi Puspita(3), Guiddo Ilyasa(4), Agus Supartoto(5)

(1) Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Sardjito General Hospital, Yogyakarta, Indonesia
(2) Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Sardjito General Hospital, Yogyakarta, Indonesia
(3) Ophtalmology Research Unit, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(4) Ophthalmology Research Unit, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(5) Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(*) Corresponding Author


Coronavirus disease (COVID-19) is a public health emergency of international concern as declared by the World Health Organization on 30 January 2020. Currently, COVID-19 is spreading rapidly worldwide, with no proven treatment nor vaccination, thus infection control measures are paramount. The severity of the majority of COVID-19 cases is mild to moderate, with fever as its most common symptoms, followed by dry cough and fatigue. COVID-19 initially reported to be transmitted from bats but then evolved into human-to-human via droplets. Coronavirus has been detected in tears and conjunctival secretions, but there is still a controversy about whether the virus can be transmitted through tears. However, the ocular transmission might be transported through a lacrimal duct to nasopharyngeal mucosa and then cause an infection. Because the nature of close contact in doctor-patient interaction during ophthalmologic practice, strict measures must be taken to minimize the impact both on the patients and health care workers.


coronavirus; COVID-19; ocular; transmission; ophthalmologist

Full Text:



  1. World Health Organization. Coronavirus disease (‎COVID-19)‎: situation report, 146. Geneva: World Health Organization; 2020 2020-06-14.
  2. Lim LW, Yip LW, Tay HW, Ang XL, Lee LK, Chin CF, et al. Sustainable practice of ophthalmology during COVID-19: challenges and solutions. Graefe's Archive for Clinical and Experimental Ophthalmology. 2020:1-10.
  3. Lai TH, Tang EW, Chau SK, Fung KS, Li KK. 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.
  4. Sun C-b, Wang Y-y, Liu G-h, Liu Z. Role of the eye in transmitting human coronavirus: what we know and what we do not know. Frontiers in Public Health. 2020;8:155.
  5. Yu A-Y, Tu R, Shao X, Pan A, Zhou K, Huang J. A comprehensive Chinese experience against SARS-CoV-2 in ophthalmology. Eye and Vision. 2020;7:1-9.
  6. Guo Y-R, Cao Q-D, Hong Z-S, Tan Y-Y, Chen S-D, Jin H-J, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak–an update on the status. Military Medical Research. 2020;7(1):1-10.
  7. Contini C, Di Nuzzo M, Barp N, Bonazza A, De Giorgio R, Tognon M, et al. The novel zoonotic COVID-19 pandemic: An expected global health concern. The Journal of Infection in Developing Countries. 2020;14(03):254-64.
  8. She J, Jiang J, Ye L, Hu L, Bai C, Song Y. 2019 novel coronavirus of pneumonia in Wuhan, China: emerging attack and management strategies. Clinical and translational medicine. 2020;9(1):1-7.
  9. Gegúndez-Fernández JA, Zarranz-Ventura J, Garay-Aramburu G, Muñoz-Negrete FJ, del Barrio JM, Pablo-Júlvez L, et al. Recommendations for eye care during the alarm state by the coronavirus disease pandemic COVID-19. Archivos de la Sociedad Española de Oftalmología. 2020.
  10. Gharebaghi R, Desuatels J, Moshirfar M, Parvizi M, Daryabari S-H, Heidary F. COVID-19: Preliminary Clinical Guidelines for Ophthalmology Practices. Medical Hypothesis, Discovery and Innovation in Ophthalmology. 2020;9(2):149.
  11. Veritti D, Sarao V, Bandello F, Lanzetta P. Infection control measures in ophthalmology during the COVID-19 outbreak: A narrative review from an early experience in Italy. European Journal of Ophthalmology. 2020:1120672120927865.
  12. Safadi K, Kruger JM, Chowers I, Solomon A, Amer R, Aweidah H, et al. Ophthalmology practice during the COVID-19 pandemic. BMJ Open Ophthalmology. 2020;5(1):e000487.
  13. Lotfi M, Rezaei N. SARS‐CoV‐2: A comprehensive review from pathogenicity of the virus to clinical consequences. Journal of Medical Virology. 2020.
  14. Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020.
  15. Dockery DM, Rowe SG, Murphy MA, Krzystolik MG. The Ocular Manifestations and Transmission of COVID-19; Recommendations for Prevention. The Journal of Emergency Medicine. 2020.
  16. Ma D, Chen C-B, Jhanji V, Xu C, Yuan X-L, Liang J-J, et al. Expression of SARS-CoV-2 receptor ACE2 and TMPRSS2 in human primary conjunctival and pterygium cell lines and in mouse cornea. Eye. 2020:1-8.
  17. Zhou L, Xu Z, Castiglione GM, Soiberman US, Eberhart CG, Duh EJ. ACE2 and TMPRSS2 are expressed on the human ocular surface, suggesting susceptibility to SARS-CoV-2 infection. The Ocular Surface. 2020.
  18. Wang P, Chen J, Zheng A, Nie Y, Shi X, Wang W, et al. Expression cloning of functional receptor used by SARS coronavirus. Biochem Biophys Res Commun. 2004;315(2):439-44.
  19. Sun Y, Liu L, Pan X. Binding action between SARS-CoV S666 protein and ACE2 receptor in eyes. Rec Adv Ophthalmol. 2007;27(4):250-3.
  20. Romano MR, Montericcio A, Montalbano C, Raimondi R, Allegrini D, Ricciardelli G, et al. Facing COVID-19 in Ophthalmology department. Curr Eye Res. 2020;45(6):653-8.
  21. Zhang M, Xie H, Xu K, Cao Y. Suggestions for disinfection of ophthalmic examination equipment and protection of ophthalmologist against 2019 novel coronavirus infection. [Zhonghua yan ke za zhi] Chinese journal of ophthalmology. 2020;56:E001-E.
  22. Chan W, Liu D, Chan P, Chong K, Yuen K, Chiu T, et al. Precautions in ophthalmic practice in a hospital with a major acute SARS outbreak: an experience from Hong Kong. Eye. 2006;20(3):283-9.
  23. Li J-PO, Lam DSC, Chen Y, Ting DSW. Novel Coronavirus disease 2019 (COVID-19): The importance of recognising possible early ocular manifestation and using protective eyewear. BMJ Publishing Group Ltd; 2020.
  24. World Health Organization ROftWP. Role of primary care in the COVID-19 response. Manila : WHO Regional Office for the Western Pacific. 2020:8.
  25. Sarti TD, Lazarini WS, Fontenelle LF, Almeida APSC. What is the role of Primary Health Care in the COVID-19 pandemic? Epidemiologia e Serviços de Saúde. 2020;29.
  26. Lim WH, Wong WM. COVID-19: Notes From the Front Line, Singapore’s Primary Health Care Perspective. The Annals of Family Medicine. 2020;18(3):259-61.
  27. Douglas KA, Douglas VP, Moschos MM. Ocular Manifestations of COVID-19 (SARS-CoV-2): A Critical Review of Current Literature. In Vivo. 2020;34(3 suppl):1619-28.
  28. Wu D, Wu T, Liu Q, Yang Z. The SARS-CoV-2 outbreak: what we know. Int J Infect Dis. 2020.
  29. Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
  30. Chodosh J, Holland G, Yeh S. Important coronavirus updates for ophthalmologists. American Academy of Ophthalmology; 2020. 2020.
  31. Hu VH, Watts E, Burton M, Kyari F, Mathenge C, Heidary F, et al. Protecting yourself and your patients from COVID-19 in eye care. Community Eye Health. 2020;33(108):S1.

font-family:"Times New Roman",serif;mso-fareast-font-family:Calibri;mso-fareast-theme-font:




Article Metrics

Abstract views : 4025 | views : 2367


  • There are currently no refbacks.

Copyright (c) 2020 Journal of Community Empowerment for Health

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.