We are all familiar with the most common symptoms of COVID-19: fever, ongoing cough, and loss or change in the sense of smell or taste. But some symptoms and potential side effects uncovered by researchers have been more surprising, including this one: A new study, published Feb. 16 in the journal Radiology, found that some COVID-19 patients had developed nodules in their eyeballs.
What the new study said
The small study involving 129 French patients was a systematic review of brain MRIs performed in patients with severe COVID-19, study lead author Dr. Augustin Lecler of the University of Paris told Health. Ocular nodules, a general term that commonly refers to a localized area of inflammation in or on the eye, was an unexpected finding, says Dr. Lecler.
“We did not think we would discover any ophthalmologic abnormalities, as COVID-19-related ophthalmic involvement is very rare,” explains Dr. Lecler. “Quickly, we found these intriguing nodules from the posterior pole of the eyeball [the eyeball] that were only visible in the most severe patients: those placed in the prone position [meaning they were lying on their stomachs], intubated on high flow supplemental oxygen. and sedated. ” Dr. Lecler says they were surprised to see the nodules, because “they had never been described before.”
In patients with nodules, the images produced by brain scans reveal at least one nodule in the macular region of the eye, which is an integral part of central vision. While researchers don’t know the exact cause of the nodules, they may be related to inflammation caused by the virus. Another theory is that the nodules could have been caused by the prone position itself; all affected patients in the study had been lying prone when in intensive care.
Did COVID cause the nodules?
Not known. Nodules can attach to the eyeballs for many different reasons, including inflammation, infection, and cancer, Raphael Aharon, MD, a board-certified ophthalmologist in Forest Hills, New York, tells Health. He notes that in the French study, only three patients underwent eye exams and were considered normal.
“If you can’t make a correlation between what’s on an MRI and an ophthalmic exam, then it really isn’t helpful,” says Dr. Aharon. “In the future, for patients who have MRI findings, a clinical correlation through extensive ophthalmic examination would make it more relevant.”
Dr. Aharon also notes that the nodules could be an incidental finding on MRI without a clinical consequence. But if a clinical correlation could be found through further investigation, that would make it more important.
Dr. Lecler confirms that no abnormalities were detected during a fundoscopy (a test that allows a healthcare professional to see inside the fundus and other structures, which is performed routinely as part of an eye exam) or using OCT, a high-resolution technique to image the posterior pole of the globe.
This means that the researchers were unable to establish a connection between MRI and dedicated eye exams. “We are planning to perform radiological-pathological correlations in deceased patients, which will give us a better understanding of the precise nature of the nodules,” he says.
Other ways COVID might affect eye health
Scientists are still trying to figure out exactly how COVID-19 might affect overall eye health. In June 2020, a case study from the University of Alberta, published in the Canadian Journal of Ophthalmology, said that pink eye (also known as pink eye or pink eye) may be a leading symptom of COVID-19, according to a study of 29 years. an elderly woman with severe conjunctivitis and minimal respiratory symptoms who tested positive for COVID-19. “Red eyes are not a common manifestation of COVID-19, but it has been reported,” Kathryn A. Colby, MD, director of the department of ophthalmology at NYU Langone Health, previously told Health.
The American Academy of Ophthalmology has also said that the coronavirus can cause conjunctivitis. However, the Centers for Disease Control and Prevention (CDC) does not include this in their list of known COVID-19 symptoms.
Another recent study, published in BMJ Open Ophthalmology, links eye problems to COVID-19. Researchers from the UK suggested that sore and itchy eyes could be an early sign of infection, starting as early as two weeks before other symptoms appear. The study also mentioned photophobia (sensitivity to light) as another possible sign of COVID-19 infection.
Information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, some data may have changed since its publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and your local public health department as resources.
