Marchenko N R, Kasparova E A, Budnikova E A, Makarova M A
Research Institute of Eye Diseases, Moscow, Russia.
Vestn Oftalmol. 2021;137(6):142-148. doi: 10.17116/oftalma2021137061142.
Conjunctivitis may appear as the first symptom of the coronavirus infection (COVID-19). In isolated cases, the lesion of the conjunctiva evokes a systemic infectious process. Currently, the conjunctiva is not considered as an area of long-term reproduction of coronavirus, and its damage is caused by hyperproduction of pro-inflammatory cytokines (especially IL-6); development of iridocyclitis and keratoconjunctivitis is also possible. Most often, local corticosteroids are used to treat these processes, although their use requires caution due to the risk of activating secondary infection (herpetic bacterial, fungal), which often develops as a result of immunodeficiency caused both by COVID-19 and the massive corticosteroid and antibiotic therapy employed when the course of the disease is severe. The severe condition of patients, the lung ventilation, and the prone position all contribute to corneal erosions, exposure keratopathy, pseudomonas aeruginosa keratitis and angle-closure glaucoma attacks. The risk of transmission of coronavirus infection during keratoplasty is estimated as minimal.
结膜炎可能是冠状病毒感染（COVID-19）的首发症状。在个别情况下，结膜病变会引发全身性感染过程。目前，结膜不被视为冠状病毒长期繁殖的部位，其损伤是由促炎细胞因子（尤其是IL-6）过度产生所致；也有可能发展为虹膜睫状体炎和角膜结膜炎。治疗这些病症最常用的是局部皮质类固醇，但由于存在激活继发感染（疱疹性、细菌性、真菌性）的风险，使用时需谨慎，继发感染往往是由COVID-19以及疾病严重时大量使用皮质类固醇和抗生素治疗导致的免疫缺陷引起的。患者的重症状态、肺通气以及俯卧位均会导致角膜糜烂、暴露性角膜病变、铜绿假单胞菌角膜炎和闭角型青光眼发作。角膜移植术中冠状病毒感染的传播风险估计极小。
