We wear mouth and nose protection, keep our distance, wash our hands, but can we also get infected with the coronavirus through our eyes? Ophthalmologists consider the risk of infection via the conjunctiva to be low. However, some questions are still open.
Just like the mouth and nose, the eyes can also be a gateway for pathogens. But can you also get infected with the SARS-CoV-2 coronavirus through your eyes? In fact, some studies point to this possibility. In relevant studies, about seven percent of COVID-19 patients experienced subjective eye complaints and one percent found conjunctivitis. The tear film is also discussed as a possible carrier.
Ophthalmologists are now commenting on this. At a press conference as part of the DOG Congress of the German Ophthalmological Society, Professor Dr. Clemens Lange from the Freiburg University Medical Center: “Some studies postulate that in these cases the virus used the eye as a gateway,” emphasized Lange. It is possible that people rubbed their eyes with hands contaminated with COVID-19. In this case, transmission to the nasal mucosa or the airways would be conceivable.
And how does it look the other way round? Can infected patients transmit the virus to healthy people through their tear fluid? The eye expert considers this transmission route to be rather unlikely. “The regular blinking of the eye and the small surface of the eye should prevent sufficient viruses from getting into the eye,” emphasizes Lange. And there is no clear indication of whether infected people could infect healthy people through their tears: “In patients with COVID-19, the tear film very rarely contains virus RNA,” explains Lange. Infection through the tear fluid should therefore first be ruled out.
Overall, the expert considers the risk of infection via the conjunctiva and tear fluid to be low. “If you finally consider the current study situation, however, nothing indicates that we have to regard the eyes as an important entry or exit point for the virus.”
Ophthalmologists see little risk of infection
A causal connection between the conjunctivitis observed in studies in COVID-19 disease cannot yet be clearly determined. “It could also be a SARS-CoV-2-independent phenomenon that occurs, for example, in the course of intensive medical treatment or the generalized inflammatory reaction in the body of COVID19 patients,” explains Lange.
The coronavirus multiplies rapidly in the body cells of infected people. To do this, the virus has to multiply its genetic make-up.
ACE2 receptor is absent in the conjunctiva
The question of whether the virus can even enter the body through the eyes has not yet been clearly clarified. To do this, the cells of the surface of the eye would have to have the ACE2 receptor to which the coronavirus binds. A current study at the University Eye Clinic in Freiburg and histological examinations from other clinics have not been able to demonstrate any significant expression of ACE2 in the conjunctiva or a connection between COVID-19 infection and conjunctivitis.
Lange comes to the conclusion that aerosols are significantly more infectious than tear fluid or the conjunctiva. “All in all, ophthalmologic examinations of aerosols from the respiratory tract are likely to pose a significantly higher risk of infection with COVID-19 than from the tear film and the surface of the eyes of the patient.” to obtain.
Nevertheless, clinical staff should protect their eyes with glasses as a precaution when providing intensive care for COVID-19 patients.
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