Experts at Dr. Agarwal’s Eye Hospital warn of 'Uveitis' - a form of eye inflammation on the rise in COVID-19 patients in Coimbatore
Coimbatore: In the wake of 10-15 new cases of 'Uveitis[ a month, after the second wave of the Covid-19 pandemic, experts at Dr. Agarwal's Eye Hospital warned public and urged COVID-19-recovered patients to be vigilant and seek medical intervention immediately since 'Uveitis' could lead to permanent vision loss.
“There is an increase in the number of patients with 'Uuveitis,' a form of eye inflammation in the Coimbatore region owing to the COVID-19 pandemic. We get about 10-15 new patients with 'Uveitis' per month at our hospital in the city. This is about 5 new patients a month,” stated Dr. Adithya G and Dr. Jayshree Arunaprakash, Consultant – Ophthalmologist, Dr Agarwal’s Eye Hospital, Coimbatore. Though the link between Uveitis and COVID-19 is not well established as yet, the most common feature of new Uveitis patients is a past history of COVID-19 infection.
The early symptoms of Uveitis are redness, sensitivity to light, floaters and diminished vision. COVID-19 recovered patients are urged to seek medical intervention immediately when they develop these symptoms, as the vision loss due to Uveitis may be irreversible, and the treatment must continue as long as the inflammation is active.
Participating in a virtual media interaction on ‘Ophthalmic Manifestations of COVID-19,’ Dr. Adithya, Consultant – Ophthalmologist, Dr. Agarwal’s Eye Hospital stated that Uveitis patients are of all age groups, from 12 to 65 years. “We believe that some immunological reaction could be triggering Uveitis. In most cases, the blood tests of Uveitis patients show elevated inflammatory markers and positive COVID-19 antibodies. There have been Uveitis cases in both the first and the second wave of COVID-19 in Coimbatore. But we see more cases after the second wave, maybe due to the new strain or the increase in COVID-19 caseload during the second wave in Coimbatore,” opined Dr. Adithya.
“We need more patients and a study involving longer periods of time to determine whether new Uveitis cases could be directly related to COVID-19, or they are just an association. The standard treatment is steroids in the form of drops or tablets depending on the severity," added Dr. Adithya.
Talking about the COVID-19 and eye health, Dr. Jayshree Arunaprakash, Consultant–Ophthalmologist from Dr. Agarwal’s Eye Hospital said, “It is well established that COVID-19 can affect all organs of the body, and eyes are no exception. Possibilities of developing some form of ocular issues either during or after the infection are significant. The biggest risk factor is that COVID-19 infection has been linked to thrombosis, that is, the formation of blood clots in blood vessels that block blood flow.
Since the vessels in the eyes are too narrow, a blood clot can easily stop the blood supply to the retina. Hence, retinal damage due to vascular blockages are possible in COVID-19 patients. This increases the risk of retinopathy, a kind of retinal vascular disease. There are also cases of patients developing nodules, which are abnormal swelling of cells or tissues, especially in the posterior pole and outside of the macular region," she added.
Citing recent studies, Dr. Jayshree Arunaprakash also highlighted that eye complications such as eye redness, sore eyes, sensitivity to light and eye pains are common in close to 10 percent of the COVID-19 patients but a significant percent of the recovered patients reported such eye issues within weeks or months of their recovery. "The risk of serious viral and fungal infections is high especially among people who recovered from severe infections and had long stays at hospitals.
People should not ignore their vision-related complications as something to do with post-COVID fatigue. Instead, they must get their eyes screened by a specialist immediately. In addition to conjunctivitis, mucormycosis, herpes zoster ophthalmicus, and uveitis, COVID-19 infection can also result in optic neuritis, swelling that damages the optic nerve. Herpes zoster ophthalmic causes skin eruptions and excoriations involving the eyelid and the surrounding areas, and mucormycosis, commonly referred to as black fungus could result in stuffiness in the nose, dark discharge, swelling around eyes, foul smell or blurred or double vision," she emphasised. .
Dr. Adithya urged people to protect their eyes from coming into contact with COVID-19 virus by wearing glasses when in crowded areas and not touching eyes unnecessarily. "The moment they develop red eyes, which could be the first symptom of COVID-19 infection, they should seek medical consultation immediately, since he effects of COVID-19 infection keeps them vulnerable for various severe viral and fungal infections for at least about six months, after the recovery" added Dr. Adithya.
On steroid-related ocular complications, Dr. Jayshree Arunaprakash said since COVID-19 primarily affects the lungs, the use of steroids to mitigate serious complications of the lungs and other organs can become unavoidable. "But steroids are known to suppress the immune system, and this creates the possibility for viral and fungal infections. Hence, eye evaluation is important especially for the patients who had prolonged ICU stay, and those who have undergone treatment involving invasive oxygen therapy and steroids.
The COVID-19 designated hospitals must take steps to screen the eyes of patients. They must look for specific signs and conduct appropriate tests for vision-threatening complications when patients complain of vision loss. Retina and cornea specialists are often required for proper evaluation and treatment of eyes," she added.
Stressing on the importance of voluntary eye screening, she further added, “The focus of the COVID-19 treatment is rightly on keeping the vitals in check, ensuring that the patients breathe on their own, and reducing the viral load. This could mean that many of the ocular symptoms might go unnoticed while patients are getting treated for the infection. Hence, patients upon recovery can get their eyes tested on their own by engaging a specialist.”