Servicio de Oftalmología, Hospital Ramón y Cajal, Madrid, España.
Servicio de Oftalmología, Hospital Clínico San Carlos, Madrid, España.
Arch Soc Esp Oftalmol (Engl Ed). 2021 Jan;96(1):32-40. doi: 10.1016/j.oftal.2020.07.020. Epub 2020 Aug 8.
In this review, a summary is presented of the main reports regarding the potential ocular manifestations of the new coronavirus disease (COVID-19). Scientific evidence is based on letters to the editor, clinical cases and case series, cross-sectional, and a few longitudinal studies. To date, it includes viral conjunctivitis, immune conjunctivitis, and oculomotor palsies (OCP) due to the novel coronavirus. Retinopathy is discussed. A viral conjunctivitis outbreak can be isolated or associated with the systemic picture, mainly pulmonary, before or after the onset of respiratory symptoms. It can be both unilateral and bilateral, follicles are typical, and duration is variable between 5 and 21 days. Immune-mediated conjunctivitis consists of eye redness, together with erythroderma and fever. It appears more frequently in children, and has been associated with a «Kawasaki-like» disease and toxic shock syndrome. OCP can present on its own, or as part of Miller-Fisher syndrome, along with ataxia, and hyporeflexia. Ophthalmologists have a considerable risk of developing COVID-19 due to close contact with the patient, exposure to tears and eye secretions, and the use of various pieces of equipment and devices susceptible to contamination.
在这篇综述中,总结了有关新型冠状病毒疾病(COVID-19)可能出现眼部表现的主要报告。科学证据基于给编辑的信、临床病例和病例系列、横断面和一些纵向研究。迄今为止,它包括病毒性结膜炎、免疫性结膜炎和新型冠状病毒引起的眼运动神经麻痹(OCP)。讨论了视网膜病变。病毒性结膜炎暴发可在呼吸道症状出现之前或之后单独发生或与全身情况(主要是肺部)相关。它可以是单侧的,也可以是双侧的,滤泡是典型的,持续时间在 5 到 21 天之间不等。免疫介导性结膜炎表现为眼红,伴有红皮病和发热。它在儿童中更为常见,与“川崎病样”疾病和中毒性休克综合征有关。OCP 可以单独出现,也可以与共济失调和反射减退一起出现在米勒-费舍尔综合征中。由于与患者密切接触、接触眼泪和眼分泌物以及使用各种易受污染的设备和器械,眼科医生患 COVID-19 的风险相当大。