The American Academy of Ophthalmology recently published recommendations for “coronavirus eye safety,” including how to limit the spread of COVID-19 infection using best practices for contact lens wearers.
Recommendations for contact lens wearers include ways to properly clean, store and wear lenses, as well as wearing eyeglasses in place of lenses because lens wearers often touch their eyes.
“I would advise not wearing contact lenses,” Francis S. Mah, MD, an OSN Cornea/External Disease Board Member, told Healio/OSN. “If we are touching things in general and then contact lenses and we transmit it to our mouth, nose and eyes, we can contract the virus.”
The AAO recommends, when storing contacts, to not store or rinse lenses in water, to not reuse old solution to store lenses, and to not transfer contact lens solution into smaller travel-sized bottles. Suggestions include using the “rub and rinse” method when cleaning contacts, not using saline solution and rewetting drops to disinfect lenses, and cleaning the lens case or replacing it regularly, at least every 3 months, to reduce the risk for contamination and infection.
When wearing contact lenses, minimizing contact with water when swimming, showering or using hot tubs, thoroughly washing and drying hands before handling lenses, and not using cracked or damaged lenses are recommended.
“People should just keep everything away from their eyes these days,” Christopher J. Rapuano, MD, director of the Cornea Service at Wills Eye Hospital, told Healio/OSN. “As you know, contact lens wearing means taking your finger and putting the lens in your eyes. Lenses can cause irritation and lead to rubbing of the eyes and dryness, and may lead to an increased chance of getting the infection.”
Conjunctivitis
According to the AAO, coronavirus-related pink eye develops in 1% to 3% of patients infected with COVID-19 and may be indistinguishable from other viruses.
Rapuano said he does not believe a red eye is an early sign of COVID-19 infection, but conjunctivitis can accompany other more concerning signs of viral infections, such as fever and respiratory symptoms.
“Just because someone has a red eye doesn’t mean they have a viral infection,” he said. “Having said that, patients with a flu-like illness can also get red eye that comes along with it.”
Mah said that available data indicate that less than 1% of patients with COVID-19 infection presented with conjunctivitis and no fever, and the risk for long-term ocular damage is minimal.
“The problem is that the ocular symptoms aren’t really horrible. There’s very little morbidity to the eye itself,” Mah said, adding that treatment is focused on minimizing the spread of infection.
Rapuano recommends supportive care in cases of viral conjunctivitis, including not wearing contact lenses and using artificial tears and cold compresses. If worse symptoms occur, then the patient needs to be reevaluated for adenovirus, for example.
“Adenoviral pink eye usually comes and goes over a week or two and is very contagious. A bad adenoviral conjunctivitis can cause significant problems,” Rapuano said. – by Earl Holland Jr.