COVID-19, caused by the SARS-CoV-2 virus, is typically spread through infected air droplets that are expelled from the nose and mouth, and then inhaled by other people. There is growing concern among the medical community that the disease may also be transmitted through contact with the eyes.

Doctors fear that touching the eyes to insert or remove contact lenses can transmit the virus. (Learn More). Individuals who wear contact lenses touch their eyes three to four times more often than those with glasses. It is believed that unnecessary contact with the face and eyes can increase the likelihood of transmission.

As a result, ophthalmologists encourage patients to stop wearing contact lenses and switch to wearing glasses when needed. This reduces the action of touching the eyes, and it also offers some physical covering to protect the eyes from infected air droplets. (Learn More)

What is known about SARS-CoV-2 suggests that the likelihood of developing COVID-19 through eye transmission is significantly lower than transmission by inhalation. But given how easy it is for viruses and other substances to come into contact with the eyes, doctors suggest exercising full caution during the pandemic. (Learn More)

 

Contacts & COVID-19

As much as 75 percent of the adult population wears some form of vision correction, reports NBC Washington. Ophthalmologists and public health experts warn that this presents a unique risk during the COVID-19 outbreak.

The concern is based on fears that the SARS-CoV-2 virus (the form of coronavirus that causes the COVID-19 disease) can be transmitted through the membrane of the eyes via infected air droplets from the coughing, sneezing, talking, laughter, or singing of a patient infected with the virus.

The danger, says the American Academy of Ophthalmology, is that people who wear corrective lenses (either eyeglasses or contact lenses) are more likely to touch their faces without even realizing it. That means that if the SARS-CoV-2 virus is on their fingers — from touching a contaminated surface, for example, or shaking the hand of someone who may have the virus — the droplets on their fingers come in close proximity to the nose, mouth, and eyes.

People with corrective lenses tend to touch their faces subconsciously, said the American Journal of Infection Control in a 2015 study. They do so more than 20 times an hour, making direct physical contact with their eyes, nose, or mouth 44 percent of the time.

When the fingers have to come into very close contact with the eyes (to insert or remove a contact lens, for example), the possibility of exposing the membrane of the eye to the SARS-CoV-2 virus (or any other foreign particle) increases. Doctors suggest that people who need vision correction should switch to eyeglasses since this offers the eyes a degree of protection.

 

Are Glasses Better?

On one level, the eyes themselves are unlikely to be touched when putting your glasses on. There is also the benefit that glasses act as a rudimentary face shield, blocking contaminated air particles from reaching the eyes.

Of course, this does mean that glasses will need to be regularly and thoroughly washed (which should be done anyway). It also means that you should wash your hands with soap and hot water often, for at least 20 seconds.

How to Stay Safe if You Must Wear Contacts

Some people are unable to wear glasses. They may need to wear other forms of protective eyewear, and they need contact lenses for vision correction.

A possible workaround for people who can’t wear glasses is to use single-use contacts. New and sterile lenses will then be worn on a daily basis. Any contamination on the old lenses will be disposed of with the lenses themselves. Daily disposable lenses are the best option for this.

If you have to use your standard contact lenses, what is the best way to keep them clean and free of the SARS-CoV-2 virus? The American Academy of Ophthalmology recommends cleaning and disinfecting your contact lenses as soon as you remove them and before you put them back in.

The best type of cleaning solution depends on the lenses you have, your allergies (if any), and the overall health of your eyes (such as if your eyes tend to form protein deposits). An ophthalmologist can prescribe or recommend the best cleaning solution for your situation.

You should also follow your doctor’s exact guidelines for properly cleaning and storing your contact lenses if you must continue wearing them during the COVID-19 pandemic.

 

The Likelihood of InfectionOrthokeratology contact lenses

A clinical spokesperson for the American Academy of Ophthalmology told CNN that people tend to touch their eyes more than any other part of their body. They do so for a variety of reasons, such as adjusting eyewear, brushing their hair out of their face, sending a nonverbal signal (as in flirting), or when they are tired or have a headache. The problem of exposure to viruses is compounded when people do not wash their hands regularly or well, transferring any number of foreign particles from their fingertips to their faces.

In the same way that health care workers wear eye shields when treating patients who might have COVID-19, eyeglasses provide a modicum of protection from the virus. Although, for members of the public who do not have the full complement of personal protective equipment, “it’s more likely that you’ll be infected via your mouth and your nose than your eye,” according to AAO. It is also more likely that SARS-CoV-2 will be transmitted through inhaled air droplets and not through the eyes.

 

COVID-19 & Conjunctivitis

There is no definitive proof that people will get COVID-19 from SARS-CoV-2 entering their eyes, although a doctor speaking to CNN grants that that is a “theoretical” possibility. Instead, the greater risk is that SARS-CoV-2 can cause conjunctivitis if it comes into contact with the eyes. Also known as pink eye, conjunctivitis is an inflammation of the conjunctiva, a transparent and thin layer of tissue that covers the white part of the eye (the sclera).

Neither SARS-CoV-2 nor COVID-19 is known to cause any vision problems or problems with the eye. On the other hand, conjunctivitis causes tearing, blurred vision, a stinging sensation in the eye, and a clear discharge. This all turns the sclera pink or red.

Although initial reports out of China showed that 1 to 3 percent of people who fell ill with COVID-19 had conjunctivitis, doctors are quick to stress that having red or pink eyes is not necessarily a sign of the coronavirus. A person who has red or pink eyes is not necessarily contagious with SARS-CoV-2; in most cases, they won’t have COVID-19. There are a number of viruses that can cause conjunctivitis, including SARS-CoV-2, in the same way that any number of bacteria or allergies can give eyes a red appearance.

 

Contact Lenses, Conjunctivitis & COVID-19healthy vs conjunctivitis

For people who use contact lenses, this presents another point of exposure. Many viruses can easily adhere to the conjunctiva, and they can also alight on a contact lens that is already resting on the conjunctiva.

Conjunctivitis caused by a virus is highly contagious. It can be passed from person to person by coming into contact with the liquid discharge from the eyes of a patient.

The telltale red eyes of conjunctivitis, along with shortness of breath, fever, and cough, could suggest the presence of COVID-19. This combination of symptoms requires an immediate call to your doctor.

Red eyes alone (without any other symptoms) will likely not indicate the presence of the coronavirus. Irritated or pink eyes could be due to any number of factors that can be treated with over-the-counter medication, home remedies, and lifestyle changes.

For patients who use contact lenses, this is a good opportunity to switch to eyeglasses. This switch will reduce contact with the conjunctiva and lessen the likelihood of exposing the conjunctiva to unclean fingers. This also presents an opportunity to practice or improve self-hygiene, such as washing your hands regularly and properly (with hot water and soap for 20 seconds), practicing social distancing, and not touching your eyes and face.

Regular implementation of these methods will slow down the spread of the coronavirus and greatly reduce the risk of transmitting COVID-19. If you wear contact lenses, it’s best to switch to eyeglasses while the pandemic is ongoing.

 

References

Should You Wear Glasses or Contact Lenses During Coronavirus? (April 2020). NBC Washington.

Face Touching: A Frequent Habit That Has Implications for Hand Hygiene. (February 2015). American Journal of Infection Control.

Brody: Glasses as Accessory, and a Shield for Your Eyes. (July 2019). Herald-Tribune.

Common Degenerative Eye Disease May Be Triggered by Tiny Mineral Deposit. (January 2015). Science Daily.

Do You Wear Contact Lenses? You Should Switch to Glasses to Stop Spreading the Virus. (March 2020). CNN.

COVID-19 and Your Eyes. (March 2020). WebMD.

COVID-19 May Be Transmitted Through the Eye, Report Finds. (April 2020). American Journal of Managed Care.

Contacts vs. Glasses. (March 2020). WebMD.

Contact Lens Institute Shares New CDC Guidance for Contact Lens Wear and COVID-19. (April 2020). Yahoo! Finance.

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