Department of Ophthalmology, University of South Florida, Tampa, FL, USA.
Department of Chemistry, University of South Florida, Tampa, FL, USA.
Med Hypotheses. 2020 Oct;143:110082. doi: 10.1016/j.mehy.2020.110082. Epub 2020 Jul 9.
A pandemic outbreak of a viral respiratory infection (COVID-19) caused by a coronavirus (SARS-CoV-2) prompted a multitude of research focused on various aspects of this disease. One of the interesting aspects of the clinical manifestation of the infection is an accompanying ocular surface viral infection, viral conjunctivitis. Although occasional reports of viral conjunctivitis caused by this and the related SARS-CoV virus (causing the SARS outbreak in the early 2000s) are available, the prevalence of this complication among infected people appears low (~1%). This is surprising, considering the recent discovery of the presence of viral receptors (ACE2 and TMPRSS2) in ocular surface tissue. The discrepancy between the theoretically expected high rate of concurrence of viral ocular surface inflammation and the observed relatively low occurrence can be explained by several factors. In this work, we discuss the significance of natural protective factors related to anatomical and physiological properties of the eyes and preventing the deposition of large number of virus-loaded particles on the ocular surface. Specifically, we advance the hypothesis that the standing potential of the eye plays an important role in repelling aerosol particles (microdroplets) from the surface of the eye and discuss factors associated with this hypothesis, possible ways to test it and its implications in terms of prevention of ocular infections.
一种由冠状病毒（SARS-CoV-2）引起的病毒性呼吸道感染（COVID-19）大流行爆发，促使人们针对这种疾病的各个方面进行了大量研究。感染的临床表现之一是伴随的眼表病毒感染，即病毒性结膜炎。尽管偶尔有报道称这种病毒和相关的 SARS-CoV 病毒（导致 21 世纪初的 SARS 爆发）会引起病毒性结膜炎，但在感染人群中这种并发症的发生率似乎很低（约 1%）。这令人惊讶，因为最近发现眼表组织中存在病毒受体（ACE2 和 TMPRSS2）。理论上预计病毒性眼表炎症的发生率很高，但实际上观察到的发生率相对较低，这种差异可以用几个因素来解释。在这项工作中，我们讨论了与眼睛的解剖和生理特性相关的天然保护因素的重要性，这些因素可以防止大量载有病毒的颗粒沉积在眼表面。具体来说，我们提出假设，认为眼睛的静息电位在排斥来自眼睛表面的气溶胶颗粒（微滴）方面发挥重要作用，并讨论了与该假设相关的因素、可能的测试方法及其在预防眼部感染方面的意义。
