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Although all medical specialties have been affected in some way by COVID-19, ophthalmologic concerns garnered much attention this past week. Conjunctivitis may be a symptom related to infection with SARS-CoV-2, according to some experts. H. Nida Sen, MD, director of the Uveitis Clinic at the National Eye Institute in Bethesda, Maryland, and a clinical investigator who is studying the effects of COVID-19 on the eye, suggests that people with conjunctivitis should be tested for coronavirus infection. Several recent studies have also found evidence that the virus may cause "pink eye," although the symptom does appear uncommon.
A report in the British Journal of Ophthalmology describes a 30-year-old man with confirmed COVID-19 and bilateral acute conjunctivitis. Conjunctival swab specimens remained positive for SARS-CoV-2 on days 14 and 17 after symptom onset. The authors stress, however, that conjunctival sampling may not be useful for early diagnosis of COVID-19 because the virus may not initially appear in the conjunctiva.
Contracting COVID-19 through the eye is a subject of increasing scrutiny. A recent survey found that ophthalmology was one of the top three specialties associated with a greater risk of medical residents contracting SARS-CoV-2. Notably, Li Wenliang, MD, who risked his job to spread warnings about COVID-19, was an ophthalmologist and died after contracting the virus from an asymptomatic patient.
Due to reports of conjunctivitis in patients with COVID-19 and concerns about disease spread through the eye, the American Academy of Ophthalmology (AAO) issued updated guidance. The information stresses that, because patients with conjunctivitis frequently present to eye clinics or emergency departments, ophthalmologists may well be the first clinicians to examine patients with COVID-19. As such, the AAO emphasizes proper safety precautions, including the use of disposable tonometer tips, as SARS-CoV-2 has been found in the tears of patients with conjunctivitis.
Beyond the safety concerns, ophthalmology practices have also been hit hard by COVID-19 closures and other changes. Although the severity varies by region, many in the specialty report having to furlough staff and apply for federal aid. Various practices are also investigating an expanding role for telemedicine, which previously had not been considered a natural fit for the specialty.
Although one specific ocular symptom was this week's top trending clinical topic, its popularity reflects a wider interest in ophthalmologic concerns related to the ongoing pandemic.
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Cite this: Ryan Syrek. Trending Clinical Topic: Conjunctivitis - Medscape - Jun 05, 2020.