The Mail Online reported that having red eyes, even without other symptoms, could be a “tell-tale sign” of coronavirus infection. This was based on an interview with one nurse in the US, who said she had noticed that the COVID-19 patients had redness around their eyes.

There have been a few documented cases of redness in the whites of the eyes (conjunctivitis) in people with coronavirus. However, red eyes have not been flagged up as a common symptom by symptom trackers or early studies.

A review of the evidence about signs and symptoms of coronavirus infection found the most commonly-reported were (from most to least common): fever, cough, fatigue, difficulty breathing, sputum (phlegm), shortness of breath, muscle aches, chills, dizziness, headache, sore throat, nausea or vomiting, diarrhoea and blocked nose.

Having red eyes is quite common with respiratory infections, and there can be many other causes including allergies. Therefore, having red eyes doesn’t automatically mean you have coronavirus.

 

Where did the story come from?

The Mail Online story was based on an interview with a nurse treating patients at a care home in Washington State broadcast by CNN on March 24. The nurse said: “It’s something that I witnessed in all of them (the patients). They have, like … allergy eyes.”

 

What is the basis for the claim?

The American Academy of Ophthalmology investigated the claims that coronavirus infection was linked to red eyes or conjunctivitis with a review of evidence. It found evidence from five preliminary studies that a very small proportion of patients with COVID-19 may have a viral infection of the eyes. It concluded: “Unless or until the CNN report is confirmed, existing data suggest that conjunctivitis is an uncommon event as it relates to COVID-19.”

It recommended that ophthalmologists take precautions when examining patients with signs of conjunctivitis or red eyes, because “it is possible—but not proven—that a patient with COVID-19 associated conjunctivitis could have infectious virus in their ocular secretions.”

In the UK, the Royal College of Ophthalmologists said in a statement on 19 March: “any upper respiratory tract infection may result in viral conjunctivitis as a secondary complication, and this is also the case with COVID-19.” It added: “However, it is unlikely that a person would present with viral conjunctivitis secondary to COVID-19 without other symptoms of fever or a continuous cough as conjunctivitis seems to be a late feature where it has occurred.”

It advises members to treat patients with signs of conjunctivitis but no other symptoms as usual, with very high levels of infection control.

The Oxford Centre for Evidence Based Medicine has been reviewing evidence about signs and symptoms of coronavirus infection in mild, moderate and severe cases since March 24. Their list of commonly reported signs and symptoms does not include red eyes or conjunctivitis.

 

What do trusted sources say?

The NHS continues to state that symptoms of coronavirus infection to look out for are a high temperature and a new, continuous cough. The World Health Organization says: “The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhoea.”

Analysis by EIU Healthcare, supported by Reckitt Benckiser

 

Citation

  1. CNN: Care home nurse tells of terrifying and sudden ways coronavirus struck her patients. Available at https://edition.cnn.com/2020/03/23/health/coronavirus-nurses-inside-washington-care-home/index.html (Accessed 14 April 2020)

Reading list

  1. Viral conjunctivitis and COVID-19 – a joint statement from The Royal College of Ophthalmologists and College of Optometrists. 19 March 2020. https://www.rcophth.ac.uk/2020/03/viral-conjunctivitis-and-covid-19-a-joint-statement-from-the-royal-college-of-ophthalmologists-and-college-of-optometrists/ (Accessed 14 April 2020)
  2. American Academy of Ophthalmology. Important coronavirus updates for ophthalmologists. https://www.aao.org/headline/alert-important-coronavirus-context (Accessed 14 April 2020)
  3. Oxford Centre for Evidence Based Medicine. Covid-19 Signs and Symptoms Tracker. https://www.cebm.net/covid-19/covid-19-signs-and-symptoms-tracker/ (Accessed 14 April 2020)