Table 1.
A summary of clinical ocular involvement in COVID-19 and SARS cases.
| Author | Study type | Region | No. of patients | No. of patients with ocular manifestations (%) | Clinical type (no.) | Ocular manifestations | Ocular examination methods | Ocular manifestations as initial symptoms | Duration (days)/onset date (day) | Treatment for ocular manifestations | Collection methods/virus assays | No. of patients with positive virus assay in eye specimens (%) | Sampling interval# (days)/sampling date for positive virus assay$ (day) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COVID-19 | |||||||||||||
| Symptoms with ocular virus testing | |||||||||||||
| Xia et al. (16) | Prospective case series | Zhejiang China | 30 | 1 (3.3%) | M | Viral conjunctivitis with conjunctival congestion and aqueous secretion | NR | NR | NR | NR | Cj swab/RT-qPCR | 1 (3.3%) | 7.33 ± 3.82 days/Day 3, 5 |
| Seah et al. (17) | Prospective case series | Singapore | 17 | 1 (5.9%) | NR | Conjunctival injection and chemosis | NR | 0 | NR | NR | Schirmer's strip tear collection/RT-qPCR/virus culture | 0 | 3 ~ 20 days |
| Zhang et al. (18) | Cross-sectional study | Wuhan China | 72 | 2 (2.8%) | 1 M • 1 NR |
Conjunctivitis | Slit-lamp | 0 | 4 days/Day 3 ~ 7 | Ganciclovir eye drops | Cj swab/RT-qPCR | 1 (1.4%) | 18.15 ± 7.57 days |
| Wu et al. (7) | Retrospective caseseries | Hubei China | 38 | 12 (31.6%) | 4 M • 8 S |
Conjunctival hyperemia, chemosis, epiphora, and increased secretions | Bedside flashlight | 1 | NR | NR | Cj swab/RT-qPCR | 2 (5.3%) | NR |
| Ye et al. (19) | Retrospective case series | Wuhan China | 30 | 3 (10.0%) | NR | Conjunctivitis | Slit-lamp/ Fundus |
1 | 7 ~ 10 days | Ganciclovir eye drops | Cj swab/RT-qPCR | 2/27 (7.4%)* | NR |
| Zhou et al. (20) | Retrospective case series | Wuhan China | 121 | 8 (6.6%) | 7 S • 1 M |
Itching, redness, tearing, discharge, and foreign body sensation | Penlight | NR | 15.0 ± 8.8 days | NR | Cj swab/RT-qPCR | 3 (2.5%) | NR |
| Chen et al. (21) | Case report | Shenzhen China | 1 | 1 | NR | Acute follicular conjunctivitis/unremarkable fundus | Slit-lamp/Fundus/OCT | 0 | Day 13 | Ribavirin eye drops | Cj swab/RT-qPCR | 1 | Day 14, 17 |
| Cheema et al. (22) | Case report | North America | 1 | 1 | M | Unilateral keratoconjunctivitis/unremarkable fundus | Slit-lamp/ Fundus |
1 | Day 1 | Oral valacyclovir, moxifloxacin eye drops | Cj swab/RT-qPCR | 1 | Day 3 |
| Colavita et al. (23) | Case report | Italy | 1 | 1 | NR | Conjunctivitis | NR | 0 | 17 days | NR | Ocular swab/RT-qPCR/virus culture | 1 | Day 3, 9, 13, 16, 21 |
| Khavandi et al. (24) | Case report | Iran | 1 | 1 | NR | Mucoid discharge and follicular conjunctivitis | Slit-lamp | 1 | Day 1 | NR | Cj swab/RT-qPCR | 1 | NR |
| Navel et al. (25) | Case report | France | 1 | 1 | S | Pseudomembranous andhemorrhagic conjunctivitis/no vitreous inflammation and retinal abnormalities | Slit-lamp/ Fundus |
0 | Day 17 | Azithromycin eye drops, low doses of dexamethasone | Cj scraping & swab/qPCR | 0 | NR |
| Hu et al. (26) | Case report | Xian China | 1 | 1 | M | None | NR | 0 | N/A | N/A | Cj swab/RT-qPCR/NGS | 1 | Positive for two weeks |
| Symptoms without ocular virus testing | |||||||||||||
| Guan et al. (9) |
Cohort study | China | 1099 | 9 (0.8%) | 4 S • 5 M |
Conjunctival congestion | NR | NR | NR | NR | N/A | N/A | N/A |
| Abrishami et al. (27) | Cross-sectional study | Iran | 142 | 41 (28.9%) | 31 S • 10 M |
Conjunctival hyperemia | Slit-lamp/ Fundus |
0 | NR | NR | N/A | N/A | N/A |
| Chen et al. (10) | Cross-sectional study | Wuhan China | 534 | 25 (4.7%) | •15 S • 10 M |
Conjunctival congestion | Telephone/face-to-face survey | 3 | 4.9 ± 2.6 days | Ganciclovir, tobramycin, ofloxacin eye drops, artificial tears | N/A | N/A | N/A |
| Hong et al. (8) |
Retrospective case series | Zhejiang China | 56 | 15 (26.7%) | 9 S • 6 M |
Sore eyes, itching, foreign body sensation, tearing, redness, dry eyes, eye secretions, and floaters | Questionnaire | 6 | NR | NR | N/A | N/A | N/A |
| Scalinci and Battagliola (28) | Retrospective case series | Italy | 5 | 5 | M | Isolated conjunctivitis | Slit-lamp | 5 | NR | Moxifloxacin eye drops | N/A | N/A | N/A |
| Marinho et al. (29) | Retrospective case series | Brazil | 12 | 12 | M | Hyper-reflective lesions at the level of ganglion cell and inner plexiform layers, subtle cotton wool spots, and microhemorrhages | Fundus/OCT | 0 | NR | NR | N/A | N/A | N/A |
| Daruich et al. (30) | Case report | Argentina | 1 | 1 | S | Unilateral eyelid edema and moderate conjunctival hyperemia | Telemedicine | 1 | Day 1 | NR | N/A | N/A | N/A |
| Salducci and La Torre (31) | Case report | Diamond Princess ship | 1 | 1 | M | Viral conjunctivitis with transparent serous secretions, conjunctival chemosis, and pseudomembranes | N/A | 1 | 7 days/Day 1 | Ganciclovir gel, artificial tears | N/A | N/A | N/A |
| Wu et al. (32) | Case report | Hubei China | 1 | 1 | M | Unilateral conjunctivitis and eyelid dermatitis | Flashlight | 1 | 5 days/Day 5 | NR | N/A | N/A | N/A |
| SARS | |||||||||||||
| Chan et al. (15) | Case series | Hong Kong | 20 | 0 | NR | None | NR | N/A | N/A | N/A | Cj swab/RT-qPCR | 0 | NR |
| Loon et al. (14) | Case series | Singapore | 36 | NR | NR | NR | NR | NR | NR | NR | Cj scraping & swab/RT-qPCR | 3 | Day 3 (case 1), Day 9 (case 2), Day 4 (case 3) |
| Tong et al. (33) | Case series | Hong Kong | 4 | NR | NR | NR | NR | NR | NR | NR | CURTI/qPCR | 2/4 CURTI specimens | NR |
| Yuen et al. (34) | Prospective case series | Hong Kong | 45 | 2 (4.4%) | NR | Mildly higher IOP (corticosteroid-related complication) | Slit-lamp/Fundus | NR | NR | NR | N/A | N/A | N/A |
COVID-19, Coronavirus disease 2019; SARS, Severe acute respiratory syndrome; S, severe/critical case; M, mild/moderate case; NR, not recorded; N/A, not applicable; Cj, conjunctival; RT-qPCR, reverse transcriptase quantitative polymerase chain reaction; NGS, next-generation sequencing; OCT, optical coherence tomography; CURTI, conjunctiva-upper respiratory tract irrigation.
#
An interval from COVID-19 onset to the conjunctival sampling.
$
A sampling date after COVID-19 onset for positive result of virus assay.
*
The data of symptoms from 30 patients and the data of virus testing from 27 patients were from two different isolation wards in this study.