COVID-19 Infection and Eye Pain

Many symptoms of COVID-19 have surfaced in the years since cases of the SARS-CoV-2 virus surfaced in late 2019. Although respiratory symptoms have received the most attention throughout the pandemic, eye pain is also a common complaint.

Eye pain, burning, and soreness can all develop with a COVID-19 infection. This article will explore why these issues develop, what eye pain symptoms you could have, and what a COVID-10-related eye problem means for your overall health.

Why Eye Pain Is a Symptom of COVID-19

You may develop eye pain with a COVID-19 infection for a few reasons.

On the simplest level, medications designed to help reduce congestion or treat cough can have a drying effect that can impact your eyes. Headaches, sinus pressure, and coughing or sneezing can also lead to eye symptoms like irritation, soreness, watering, or dryness.

Eye pain usually appears during the first week of a COVID-19 infection but can increase or appear later if your infection becomes more severe. Some of the most common eye-related complaints with a COVID-19 infection include:

• Soreness
• Burning
• Dryness
• Itching
• Redness
• Sensitivity to light
• Discharge
• Grittiness or the feeling of a foreign object in the eye

The eye is a known entry point for the virus. COVID-related eye infections like conjunctivitis (pink eye) have been documented throughout the pandemic. Some evidence suggests eye secretions or drainage can transmit the virus to others.

Some studies have suggested that the proximity of the eyes to nasal passages can also increase eye symptoms, especially since the viral load (measurement of the amount of virus in the body) of SARS-CoV-2 in the nasal passages is usually higher than in the throat.

Plus, headaches, nasal congestion or drainage, fever, and other symptoms of a COVID-19 infection can also cause head pain or pressure that can affect your eyes.

There also may be a connection between neurological and immune-related complications of COVID-19 and eye pain. COVID-19 infections have been found to increase your risk of neurological disorders associated with inflammation or nerve damage.

These viral infections have also been linked to autoimmune reactions (in which your immune system attacks your own cells), which could increase sensitivity in different areas of the body or even cause your own tissues to work against themselves.

Long COVID and Eye Pain

Dryness, irritation, and soreness in your eyes with an active viral infection aren't that uncommon, but some lasting eye symptoms have been included in lists of long COVID symptoms.

"Long COVID" is the term for the symptoms and ongoing complications people may experience long after their COVID-19 infection is considered resolved.

Inflammation is common with most forms of COVID-19, and ongoing eye problems are thought to stem from continued inflammation, nerve damage, and changes to your immune system after your acute illness.

Some documented eye problems that have been linked to long COVID include the following:

• "Cotton wool" spots from inflamed and damaged tissue on the surface of the eye
• Blood clots blocking arterial blood flow to the eye causing a retinal artery occlusion, a type of "eye stroke"
• Blood clots blocking the flow of blood out of your eye, or retinal vein occlusion, leading to increased fluid and swelling in the eye
• Retinal bleeding caused by blood clots or damage to blood vessels in the eye

Some of these eye problems can affect your vision and result in permanent damage.

Treatment and Management for COVID-Related Eye Pain

Most eye symptoms associated with COVID-19 resolve on their own. One study found that eye symptoms with a COVID infection went away within two weeks the active infection resolving.

For ongoing symptoms that continue after the infection, it's important to schedule an appointment with an eye care provider to rule out other conditions or complications.

Issues like dry eye, irritation, and even infection can be treated with things like eye drops, ointments, or antibiotics as recommended or prescribed by a healthcare provider. For more serious complications linked to blood clots that could affect or even destroy your vision, more intense treatments may be required.

One option for treating eye problems related to blood clots after a COVID-19 infection is intravenous medication that dissolves the clots, like Activase (alteplase). Even if the clot resolves, you could require ongoing treatment to address any permanent damage.

Generally, people who develop serious eye problems have severe forms of COVID-19 infection. Outside of the severity of the initial infection, COVID-related eye problems tend to happen more in people with preexisting conditions like:

• Diabetes
• High blood pressure
• Blood vessel disorders
• Blood disorders that can affect clotting

When to See a Healthcare Provider

In terms of your COVID-19 infection, it's important you see healthcare provider if your symptoms become severe, resulting in problems like:

• Shortness of breath
• Blue fingernails or lips
• Confusion
• Dizziness
• Chest pain

For eye problems, specifically, over-the-counter lubricating eye drops and at-home remedies like a warm compress may help most.

Don't wait, though, if your symptoms become worse or you notice that your vision is being affected. Retinal bleeding and blood clots usually appear with a sudden total loss of vision without pain. They must be treated as a medical emergency to avoid permanent vision loss.

Summary

COVID-19 infections can appear with a wide range of symptoms, including eye pain. Eye pain, soreness, and irritation usually fade in a week or two as the infection resolves. However, some COVID-related problems can lead to more severe eye problems and even vision loss.

Call your healthcare provider to schedule a more in-depth evaluation if you have vision changes during or after your COVID-19 infection.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.