En espanol | 'Tis the season for coughs, congestion and itchy, red eyes.
Any other year, these ailments would be chalked up to yet another cold and flu season. But this fall and winter, plenty of people will be wondering: Is it the coronavirus?
While there is a lot of overlap between the symptoms of COVID-19 and the more common seasonal maladies of colds and the flu — a sore throat, runny nose and cough are markers of all three, for example — a red, watery eye, on its own, likely means you're in the clear when it comes to COVID-19, says Alfred Sommer, M.D., professor of epidemiology, international health and ophthalmology at the Johns Hopkins Bloomberg School of Public Health.
Conjunctivitis — an eye infection that's more commonly known as pink eye — can be caused by a number of things, according to the Centers for Disease Control and Prevention (CDC), including bacteria, allergens and different viruses. However, “there is very little evidence that people develop pink eye from COVID-19,” the illness caused by the new coronavirus, Sommer says.
A few studies have drawn a link between conjunctivitis and the coronavirus. A report published in March in JAMA Ophthalmology found that nearly one-third of a small sample of patients with COVID-19 in Hubei province, China, had “ocular manifestations” consistent with pink eye. Most who experienced these eye symptoms had severe cases of COVID-19 (and often had pneumonia); only one patient presented with conjunctivitis as the first symptom.
Another study, also conducted in China and published in JAMA Ophthalmology in August, found that while the most common symptoms among 216 children hospitalized with COVID-19 were fever and cough, about 23 percent had symptoms matching pink eye, including conjunctival discharge, eye rubbing and conjunctival congestion. (The conjunctiva is the clear membrane that covers the white part of the eye.)
Still, Sommer says pink eye is an “unusual presentation” of a coronavirus infection. A meta-analysis of available research in the Journal of Medical Virology comes to a similar conclusion: It found the overall rate of conjunctivitis in COVID-19 patients was 1.1 percent. In patients with severe COVID-19, the incidence was slightly higher, at 3 percent.
Know the Signs of Pink Eye
Symptoms of conjunctivitis can include the following:
• Pink or red color in the white of the eye(s)
• Swelling of the thin membrane that lines the white part of the eye and the inside of the eyelid
• Increased tear production
• An urge to rub the eye(s)
• Eye itching, irritation and/or burning
• Discharge from the eye (a watery discharge signals a viral infection; a pus-like discharge points to bacterial conjunctivitis)
• Crusting of eyelids or lashes, especially in the morning
• Discomfort from contact lenses
"People who get COVID and become sick with COVID are much more likely to get all the other symptoms that you hear about, read about all the time — the coughing, loss of smell, the loss of ability to taste, and so forth,” Sommer says.
Coronavirus prevention also protects against pink eye
While pink eye is often associated with children because of its ability to spread quickly in a school setting, anyone, including older adults, can get it. “The viruses that cause pink eye don't discriminate,” Sommer says. (And pink eye is often due to a virus, he adds.)
If you develop the warning signs of pink eye — including a pink or red color in the white area of the eye, swelling of the membrane that lines the eye, and increased tear production — and are concerned about the infection and any relation it may have to COVID-19, reach out to your doctor or ophthalmologist. Pain in the eye, blurred or impaired vision, and light sensitivity warrant more immediate medical attention.
A physician can usually determine the cause of the irritated eye and then prescribe the appropriate treatment, if any is required. Antibiotics can help shorten the length of infection and reduce complications if the pink eye is caused by bacteria, the CDC says. Antiviral medication may be prescribed for severe cases of viral conjunctivitis.
"[Pink eye] is usually not dangerous; it's just uncomfortable,” Sommer says. It's also highly contagious.
The good news: A lot of the things people are doing right now to prevent the spread of COVID-19 — frequent handwashing, cleaning and disinfecting, keeping their hands away from their face — also help to block the transmission of pink eye.
"Should somebody get pink eye, the one thing they absolutely have to recognize is they need to keep their hands away from that eye” and away from other people, Sommer adds. Pink eye caused by allergens or irritants, however, is not contagious unless a secondary viral or bacterial infection develops, the CDC says.
In addition to contacting your ophthalmologist with pink-eye concerns, Sommer says older adults with certain eye conditions that require routine care — glaucoma and macular degeneration, for example — should be in touch with their eye doctors about receiving regular tests and treatments during the pandemic to prevent further eye damage. Similar to primary care practices and dentist offices, most ophthalmologists have resumed seeing patients and are practicing precautions to keep everyone safe.