COVID-19 Eye Health Guide

The COVID-19 pandemic has made it difficult for many people to access eye care the same way they once did. People postponed visits to their eye doctor or opted for virtual eye services like telehealth exams and online glasses-shopping. However, individuals with specific degenerative eye conditions must continue to receive in-person care to slow the progression of their disease. 

The pandemic has also caused additional eye health problems for many people. Spending more time in front of screens while we quarantined and distanced ourselves from friends and loved ones caused a surge of screen-related eye problems in both children and adults.

Wearing masks regularly also has caused some people to develop dry eyes. People who contract COVID-19 may develop eye-related symptoms like eye pain and discharge. Most of these effects are not permanent and will go away in time. 

Eye Conditions That Require Regular Office Visits

Even though in-office visits do pose a small risk of COVID-19 infection, some people must continue to visit their eye doctor regularly to preserve their eye health.

Patients with certain eye conditions need monthly injections to manage the progression of the disease. These include:

• Age-related macular degeneration (AMD)
• Diabetic retinopathy

Patients who do not receive injections will gradually lose more and more of their sight. Eventually, they will go blind.

The following conditions also need to be monitored regularly to minimize the chance of serious complications like blindness:

• Glaucoma
• Chronic retinal detachment

If you are not certain if you have an eye condition that requires regular visits, consult your eye doctor.

Patient Safety Tips for Optometrist and Ophthalmologist Visits

If you must see your eye doctor in person, health experts recommend these steps to follow to make your visit safer:

• Let your doctor know if you or any member of your household develops symptoms of COVID-19 before your appointment. 
• Practice social distancing during your visit. 
• Do not touch your eyes, mouth, or nose during your visit unless you have just washed your hands. 
• Wash your hands after contact with any surfaces in the office. Use soap and water and spread the lather for at least 20 seconds. 
• Use hand sanitizer to kill any virus particles on your hands when hand washing is not possible. 

What to Expect at the Eye Doctor’s Office 

Eye doctors also made changes to their office protocols to protect staff and patients against contracting COVID-19. When you need to visit you will likely be asked to:

• Book your appointment by phone. Walk-in appointments are usually not offered at this time. 
• Arrive on time. You may be asked to call the office before you enter to help reception staff manage the number of patients in the waiting area at any given time. 
• Wear a mask and wash your hands or use hand sanitizer during your visit. All staff members will do the same. 

You may also notice the following changes:

• Some staff may wear additional protection such as gloves and face shields.
• Some tests may be modified for safety reasons. Some equipment may also have had plastic or plexiglass shielding installed around it.
• Some windows and doors may be left open to improve ventilation. 

In-Person vs. Telehealth Eye Appointments

If you need to see an eye doctor at some point during the pandemic, you may be offered a telehealth visit instead of an in-person one. 

Telehealth visits are a good choice in two scenarios:

• When you have eye symptoms you can see in the mirror. ‘Floaters’ (small dark spots that travel across your field of vision), redness, discharge, and other visually obvious symptoms can all be investigated on a video feed. Depending on what your eye doctor observes during your appointment, you may need to schedule an in-person visit for treatment or further testing. 
• Appointments for routine follow-up care. Any follow-up care needed after surgery or treatment for diagnosed conditions can be done virtually. Your eye doctor will tell you if they see any signs that you need further in-person care. 

For all other vision care, find a way to visit your eye doctor in person.

Ordering Glasses Online

If you are uncomfortable shopping for glasses in person, you can purchase a pair of prescription eyeglasses from many online retailers.

In 2019, 9.3 percent of prescription glasses in the United States were sold online.

STATISTA

Online solutions for measuring your current eyeglasses prescription exist as well. However, they are not as accurate as in-person testing. They cannot detect signs of underlying health conditions or serious eye problems.

The American Academy of Ophthalmology recommends that home vision tests be used only for healthy adults aged 18 to 39 with mild to moderate prescriptions and no symptoms of eye disease. If you have any symptoms or history of eye disease or have not received an eye exam in many years, book an in-person appointment with your eye doctor instead. 

If you choose a home vision exam service, choose a provider that verifies each prescription with the help of a qualified eye doctor. After receiving your new prescription glasses, a best practice is to take them to your doctor’s office to have technicians confirm that the new prescription lenses match the prescription the doctor ordered for you. 

Finally, never order contact lenses based on the results of a home eye exam. Contact lenses must be fitted carefully to avoid irritating your eyes or potentially causing an infection. 

Eye Problems That Can Be Treated at Home

There are some eye problems that do not need to be treated by an eye doctor. Instead, you can treat them at home. Some of these problems include:

• Black eyes
• Viral pinkeye
• Irritation from seasonal allergies 
• Styes
• Eye strain 

Most of these conditions will go away on their own over time. If you experience any pain or swelling, you can apply a cold compress to your eye for relief. Over-the-counter eye drops can also be used to help treat allergies or pinkeye.

COVID-19 & Your Eyes

Approximately 10 percent of people who contract COVID-19 will develop eye-related symptoms. These include:

• Itchy eyes
• Watery eyes
• Foreign body sensation (feeling like something is stuck in your eye)
• Eye pain
• Redness
• Discharge
• Conjunctivitis

Can You Catch COVID Through Your Eyes?

Circumstantial evidence suggests that COVID-19 can be transmitted through contact between viral droplets and eye fluids. This means that touching your eyes and being around other people with your eyes uncovered may pose a risk of contracting the disease. 

Contacts and COVID-19

If you regularly wear contacts, it is safe to continue using them during the pandemic. However, you should take the following precautions to minimize the spread of infection:

• Wash your hands well before and after putting your contacts in.
• Disinfect your contact lenses regularly. 
• Do not wear your contact lenses if you develop any cold- or flu-like symptoms. 

Extended Screen Time and Eye Health

Social distancing and stay-at-home orders have led to a significant increase in screen time for many of us. This in turn has caused in certain eye problems.

In one 2021 study, 95.6 percent of respondents reported at least one eye-related symptom associated with high screen time (such as dry eyes, redness, and eye pain) since the pandemic began. Further, 56.5 percent of people who experienced symptoms before the pandemic began reported experiencing them more often or more severely than they used to.

Screen time-related eye problems are rarely permanent. In most cases, they will improve once you reduce the amount of time you spend using devices. Spending time outside can also help your recovery. 

The Impact of COVID-19 on Children’s Eyes

The pandemic has also had a significant impact on children’s eye health:

• Some eye doctors are reporting elevated rates of new and worsening nearsightedness in children in their local area. If this is true, it is likely due to spending longer periods of time looking at screens (especially during distance learning) and a lack of time spent outside. 

• Many children have developed eye-related symptoms due to increased screen time. These include dry eyes, headaches, and eye strain.

• Some children who normally wear glasses stopped wearing them during the pandemic. This is a problem because blurry vision in childhood can result in an underdeveloped vision system when the child is grown. 

• Many children stopped receiving treatment for conditions like amblyopia (lazy eye). As a result, they have lost a lot of the progress they had made before the pandemic began.

The Impact of Face Masks on Eye Health

Regular mask use during the pandemic has caused a significant increase in mask-associated dry eyes. 

This condition occurs due to the way mask use redirects the flow of your breath. Each time you breathe with a mask on, you send a gust of air over your eyes. Over time, this eventually leads to dry eyes, redness, eye pain, and other uncomfortable symptoms. 

To protect your eyes while wearing your mask:

• Use a mask with a nose clip to direct the flow of air away from the eyes.
• Improve the fit of your mask by tightening the ear loops, adding a folded tissue beneath the bridge of the nose, or taping that part of the mask to your skin. 
• Use eye drops as needed to lubricate your eyes.

Glasses, Face Shields and Other Eye Protection

Evidence suggests that wearing eyeglasses, face shields, goggles, or other eye protection can reduce your chances of contracting COVID-19.

 In a study conducted in Suizhou, China, only 5.8 percent of 276 hospitalized patients wore eyeglasses regularly compared to 31.5 percent of the general population.

JAMA Ophthalmol

If you do not wear eyeglasses regularly, you can wear other protective face wear like goggles or a face shield to produce the same effect. However, be aware that this is probably not necessary if you are following all other recommended COVID-19 safety measures. Eye protection is typically only recommended if you spend a lot of time in a high-risk setting like a hospital or long-term care home.

References

1. Increased Screen Time and Dry Eye: Another Complication of COVID-19. (July 2021). Wolters Kluwer Public Health Emergency Collection.

2. Coronavirus: ‘Eyesight of thousands at risk due to missed care.’ (June 2020). British Broadcasting Corporation (BBC).

3. Position Statement Regarding Telemedicine in Optometry. (October 2020). American Optometric Association.

4. How the COVID-19 Lockdown Changed Children’s Eyes. (July 2021). American Academy of Ophthalmology.

5. Ocular Manifestations of COVID-19: A Systematic Review and Meta-analysis. (January 2021). Journal of Ophthalmic and Vision Research.

6. Home Remedies for Simple Eye Problems. (January 2021). American Academy of Ophthalmology.

7. SARS-CoV-2: eye protection might be the missing key. (February 2021). The Lancet.

8. COVID-19 and contact lenses: the facts you need to know. (2021). University of Waterloo: Centre for Ovular Research and Education.

9. Does Eye Protection Help Avoid COVID-19? (October 2020). McGill University Office for Science and Society.

10. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. (June 2020). The Lancet.

11. Set the record straight on wearing contacts safely during COVID-19. (August 2020). American Optometric Association.

12. Using a Home Vision Test to Order Glasses Online. (July 2020). American Academy of Ophthalmology.

13. COVID-19 (Coronavirus) Eye Health Care Guide for Patients. (2021). American Optometric Association.