Experience against COVID-19 Pandemic in Ophthalmology


Journal of Clinical and Experimental Ophthalmology is a journal which provides rapid peer-review process with 6 issues per year (Bi Monthly). Journal of Clinical and Experimental Ophthalmology accepts all types of articles including case-reports, research, review, case-series, mini-review, opinion articles, short communications, commentary, perspective and video articles.

Journal of Clinical and Experimental Ophthalmology has recently release its 3rd issue in 2020 with 6 articles and 3 Research articles, 2 case reports and a short communication. Here we are mentioning about the case report entitled “Experience against COVID-19 Pandemic in Ophthalmology” written and submitted by Xufang Sun whose abstract was as follows:

The 2019 novel coronavirus disease (COVID-19) pandemic has now emerged signs of stable or in control, especiallyin China. Several studies have been conducted to identify the possible ocular route of SARS-CoV-2 infection and theocular symptoms in COVID-19 patients. Due to the close contact with patients when performing ophthalmologicexaminations or surgeries, ophthalmologists need precautionary measures during the outbreak. Here, we summarizeresearches on COVID-19 related ocular characteristics and the experience against the SARS-CoV-2 infection, hopingto help ophthalmologists and patients worldwide.

The  transmission  of  SARS-CoV-2  via the  ocular  surface  eyesshould not be overlooked. It has been proved that the entry ofSARS  cov-2  is  mediated  by  angiotensin  converting  enzyme  2(ACE2), a metallopeptidase expressed in many human tissues,including  the  cornea  and  conjunctiva  [1,2].  Besides,  a  novelroute of CD147 (extracellular matrix metalloproteinase inducer)-spike  protein  (SP)  was  found  in  promoting  SARS-CoV-2invasion into host cells [3]. CD147 was also detected in cornea,conjunctiva  and  retina  [4].  Further  study  of  animal  modelshowed that macaques could be infected with SARS-CoV-2  viathe  conjunctival  route  and  the  viruses  spread  in  bothnasolacrimal  system  and  lung  [5].  These  results  provide  amolecular basis for the transmission of SARS-CoV-2 through theeyes.A lot of case reports and observational studies suggested thatconjunctival congestion was one of the symptoms of COVID-19,and could appear as the initial symptom [6-9]. Our paper, titled“Ocular manifestations and clinical characteristics of 535 cases of  COVID-19  in  Wuhan,  China:  A  cross-sectional  study”,enrolled  535  patients  at  Mobile  Cabin  Hospital  and  TongjiHospital with mild COVID-19. 5.0% patients had conjunctivalcongestion  during  hospitalization.  Moreover,  the  averageduration of conjunctival congestion was 5.9 ± 4.5 days (mean[SD]). We further investigated the behaviors of eye protection,showing that frequent hand-eye contact may be the risk factorfor  conjunctival  congestion  in  COVID-19  patients.  For  thesepatients with conjunctivitis, the usage of ganciclovir eye drop waseffective.Except for the ocular manifestations of conjunctivitis, such asconjunctival congestion, chemosis, increased watery secretions ortearing,  no  symptom  and  lesion  associated  with  intraoculardiseases  (iritis,  choroiditis,  and  retinal  disease)  was  found  inCOVID-19 patients, which suggested that the illness seemed toconfine  to  the  ocular  surface  [7,9,10].  Recent  researches  hasproved that SARS-CoV-2 spike (S)-protein binds ACE2, and inconcert  with  host  proteases,  principally  TMPRSS2,  promotescellular entry [11]. Co-expression of ACE2 and TMPRSS2 wasdetected  in  conjunctiva  and  cornea  but  not  in  retina,  inaccordance with the clinical symptoms [12]. Thus, screening ofpatients with ocular surface discomforts by ophthalmologists isadvocated during the outbreak of COVID-19.In the early stage of the epidemic in Wuhan, China, most of theinfected medical staffs worked not in respiratory or emergencydepartment but in neurosurgery or ophthalmology departments.

Due  to  the  close  contact  with  patients  when  performingophthalmologic examinations and frequent exposure to oculardischarge,  ophthalmologists  should  pay  attention  to  theprotections  during  medical  practice  or  surgeries  and  thepossibility of cross-infection.For  patients,  online  doctor  visit  via smartphone  could  helpreducing face-to-face contact. If the preliminary treatments failto  relieve  the  ocular  discomforts,  patients  are  then  asked  tomake an appointment on “Tongji hospital”  application beforegoing  to  the  clinic.  All  patients  are  advised  to  wear  maskseverywhere  in  hospital  and  they  are  firstly  screened  throughtemperature  measurement  and  symptoms  at  emergencydepartment. A series of examinations, including blood routine,COVID-19  IgM/IgG  detection,  SARS-CoV-2  detection  innasopharyngeal swabs and chest CT are needed for patients withhigh  temperature,  respiratory  symptoms,  close  contact  withCOVID-19 diagnosed patients or before ocular surgery.

More info at: https://www.longdom.org/open-access/experience-against-covid19-pandemic-in-ophthalmology.pdf

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