Tears from individuals with and without ‘ocular symptoms’ could be a source of Covid-19 infection, suggests a recent study.

A study that looked at whether or not Covid-19 was present in the tears of positive patients with and without “ocular manifestation” found that even though respiratory droplets are the primary route of infection transmission, the risk of transmission through other routes such as faecal-oral and conjunctival secretions cannot be ignored.

The word ‘ocular manifestation’ refers to an eye disease that is caused by an illness in another region of the body, either directly or indirectly.

The study was conducted on 120 Covid-19 infected patients, 60 with ocular complaints and 60 who had no ocular manifestations — conjunctival hyperemia in 41 patients, follicular reaction in 38, chemosis in 35, mucoid discharge in 20 patients, and itching in11.

About 37% of the study participants with ocular symptoms had moderate Covid-19 infection, while about 63% had a severe infection. In the second group, about 52% of the patients had moderate disease and over 48% had severe disease.

The samples of tears were taken within 48 hours of admission from both the eyes of enrolled patients for evaluating the presence of Covid-19 by conventional reverse transcription-polymerase chain reaction (RT-PCR) method of testing, considered the gold standard in the diagnosis of Covid-19.

In total, 17.5% of patients — 21 of 120 — under evaluation for RT-PCR of tears were positive for Covid-19 out of which 11 patients (9.16%) had ocular manifestations and 10 (8.33%) did not have any ocular complaint, pointing out that coronavirus infected patients can shed the infection in conjunctival secretions even in the absence of ocular involvement.

INFECTIOUS TEARS

‘Ophthalmologists need to be more careful’
The study by Dr Prempal Kaur, Dr Gaurang Sehgal, Dr Shailpreet, KD Singh and Bhavkaran Singh observed that tears can be a potential source of infection for health care workers and called for extra caution.

It added that ophthalmologists need to be more careful because of close proximity to the patient’s nose, mouth, and tears while examining them.

It also recommended that all healthcare professionals should wear face masks and protective glasses while examining positive patients during the pandemic, in addition to maintaining strict hand hygiene.

The study published in the latest edition of Indian Journal of Ophthalmology concluded: “SARS CoV 2 can be present in tears with or without ocular involvement, therefore, prevention is the most important aspect to be remembered by all emergency physicians and ophthalmologists to protect their patients and themselves by adopting required precautions.”

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