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9 common eye diseases in COVID-19 patients

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Symptoms and Treatment including mucormycosis or black fungus

9 common eye diseases in COVID-19 patients- Symptoms and Treatment (including mucormycosis or black fungus)


In the current wave of Covid 19 pandemic, there has been a spike in the cases of black fungus or mucormycosis, as it is called in scientific terms. A lot has been talked about in media channels, however did you know that there are many other eye diseases that have been on the rise in COVID recovering or post COVID patients?

Eye complications have been recorded, even after a fortnight, in post COVID patients; hence it is important to be vigilant and report the slightest change in vision or eye condition.

Our in house eye-surgeon – Dr. Seema Khaire, talks about these nine common eye diseases and symptoms to look out for in post COVID patients, to ensure quick treatment.

  • Dry Eye
  • Conjunctivitis- pink eye/ sore eyes:
  • Keratoconjunctivitis
  • Glaucoma
  • Other inflammations in eyes like uveitis and scleritis
  • Retinal diseases in corona
  • Optic neuritis
  • Ocular nerve palsy
  • Orbital fungal infection

- Dry Eye

Dry eye is one of the most common and neglected eye problems. If you have a prolonged prick, itching or redness in the eyes, it could be because of dryness of eyes.

The common causes for Dry eye are

  • Excessive use of mobile phones or computers

  • Sanitizer fumes that affect the ocular surface and cause dry eye

  • It could also be related to seasons- summers tend to cause a spike in dry eye cases

  • Or it could be associated with masks. MADE (mask associated dry eye syndrome) has been a growing cause during the pandemic.

Treatment or remedies for dry eye

One of the simple ways to avoid MADE (mask associated dry eye syndrome) is by using a good fitting mask. You could even use some tape to seal the mask at the nose bridge to avoid exhaled air from blowing into the eye. If you use spectacles, avoid spectacle fogging.

Dry eye is caused by loss of moisture in the eyes. Keeping a wet cloth on eye lids, helps retain moisture in the eyes.

In advance cases, the eye specialist may advise the use of tear substitutes. This however, should be used only in consultation with a specialist. Do not self-medicate.

- Conjunctivitis- pink eye/ sore eyes:

Conjunctivitis cases or pink eye, as it is commonly known affects nearly 10-15% of COVID recovered patients. It is also seen as a common COVID-19 symptom in the second wave.

Symptoms of Conjunctivitis or pink eye

If you observe sustained redness or watery discharge from the eye, contact your eye doctor immediately. You might experience a loss of smell or taste and based on investigation, might be advised to take a corona test.

Treatment

Doctors usually prescribe antibiotic drops for treatment of conjunctivitis or pink eye.

A word of caution for the caregiver

Corona virus persists in the tears, even after nasopharyngeal swab tests are negative, hence it is important to wash hands or/and wear gloves while administering the eye drops to patients.

- Keratoconjunctivitis

Keratoconjunctivitis is an inflammation of both the conjunctiva and the cornea. COVID-19 patients seem to suffer from a side-effect of increased IL 6 levels. This in turn leads to Keratoconjunctivitis.

Symptoms of Keratoconjunctivitis

  • Light sensitivity

  • Burning sensation in eyes

  • Itchiness in eyes

  • Swollen eyelids

Treatment

An eye specialist would be the right person to diagnose the condition and prescribe the relevant treatment. The condition is curable and may take a few weeks to cure. Be sure to complete the treatment and follow up.

- Glaucoma

Glaucoma is a leading cause for blindness in people over the age of 60. It is an eye condition that affects the optic nerve. This eye disease is usually caused by high pressure in the eye. A pressure above 10-20mm of Hg, would require further investigation by an eye specialist.

Glaucoma cases in COVID-19 cases

  • In the current COVID-19 wave, cases on ventilator support have reported glaucoma cases.

  • Pre-existing glaucoma cases can worsen.

  • Patients with inflammation of trabecular meshwork have been diagnosed with inflammatory glaucoma .

Symptoms of Glaucoma

  • Redness

  • Decreased vision

  • Opacity/clouding of central black portion- cornea

Treatment

At the first signs of possible symptoms, connect with your eye specialist. After a detailed examination, doctor will prescribe the treatment and medication.

- Other inflammations in eyes like uveitis and scleritis

In the current wave of COVID-19, many forms of eye inflammations have been reported in patients recovering from corona. Uveitis and Scleritis are two types of eye inflammation, increasingly found in COVID recovered cases.

Symptoms of uveitis and scleritis

  • Redness

  • Photophobia

  • Pain

  • Watery discharge from the eye

Treatment

After a detailed examination, an ophthalmologist will decide the treatment and medications. It is ideally cured in a few weeks.

- Retinal diseases in corona?

Retinal diseases are those that affect any part of the retina. The retina contains millions of light-sensitive cells and other nerve cells that receive and organize visual information. Any eye disease impacting retina will cause visual distortion. Retinal diseases have emerged as a common implication in covid patients. Two types of retinal diseases have been on the rise -

Retinitis

  • It is an inflammation of the retina

Vascular occlusion

  • It is a form of blockage of the blood vessels. It could cause fluid-build up and prevent retina from functioning properly.

Symptoms of Retinal diseases

  • Sudden decrease in vision

Treatment

The treatment in retinal diseases can be long drawn. Based on the investigation by an eye specialist/ophthalmologist various treatments are recommended like -

  • Lasers

  • Injections of anti- VEGF( Vascular endothelial growth factor),

  • Steroids (depending on the stage and cause)

- Optic neuritis

Optic neuritis is the inflammation or swelling of optic nerve. If undetected, it can damage the optic nerve and cause loss of vision. Optic neuritis has been on the rise in the post COVID cases.

Symptoms

  • Eye pain that worsens with eye movement

  • Eye movement causes flashing lights

  • Reduction in vision

Treatment

After an eye examination, the eye specialist may recommend certain tests and chart a treatment plan after that. Steroids may also be used in some cases.

- Ocular Nerve Palsy

Though not very frequent, Ocular nerve palsy is another eye disease that is seen in patients affected by corona. This is an eye condition where muscles controlling eye movement are affected. It is caused by damage to the third cranial nerve or its branch.

Symptoms associated with Ocular nerve palsy

  • Small eye

  • Double vision

  • Inability to move the eye

  • Photophobia

Treatment

A detailed examination by an ophthalmologist will decide the treatment and medications for Ocular nerve palsy.

- Orbital fungal infection

Orbital fungal infection or Mucormycosis or Aspergillosis is one of the dreaded complications in the COVID-19 patients. The sudden rise in cases in post COVID cases has been a cause of worry for eye doctors all over India. While we are exposed to funguses regularly, an immunocompromised person is unable to mount an effective defence against these spores and hence it is profound in the current pandemic.

High risk patients who need to be vigilant about Orbital fungal infection

  • Patients requiring high flow oxygen or ventilator support

  • Patient receiving steroids

  • Patients with high sugar levels

Symptoms of Orbital fungal infectionn

  • Swelling around eye

  • Blood tinged nasal discharge

  • Nasal blockade, stuffiness

  • Facial pain

  • Headache

  • Discolouration of oral or nasal cavity

  • Dropping of eye lid

Treatment

The treatment of orbital fungal infection would involve the expertise of ENT surgeon and eye surgeon. In some cases neuro-surgeon and maxillofacial surgeons too are involved. It is important to have an early diagnosis of the condition, as delay in treatment can result in removal of eyeball and sinus to save the life of a patient.

Eye diseases in post COVID patients have been a matter of concern for eye specialists and there are multiple awareness programs being run by eye doctors to identify and treat patients early. Evolving treatment strategies may help in reduction of such cases in the coming days. Till then, it is important to stay safe and vigilant.

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येशवंत सिताराम संकपाल

07-06-2021

सकारात्मक विचार,जगण्याची इच्छा आणि योग्य उपचाराने कोरोना सारख्या भयानक आजारावर सुद्धा मात करता येते ह्याचे उत्तम उदाहरण म्हणजे आज डिस्चार्ज घेऊन सुखरूप घरी गेलेला एक घराचा कर्ता पुरुष.

के के हॉस्पिटल येथे २३ एप्रिल 2021 रोजी वाढत्या कोरोना रोगाची पार्श्वभूमी पाहता रुग्णांना योग्य उपचार अगदी वेळेत मिळावेत ह्या उद्धेशाने तिथे एडमिट झालो.

काही दिवसांनी ताप आला म्हणून कोविड तपासणी केल्यावर रिपोर्ट पॉझिटिव्ह आला.सगळीकडे रुग्णांची संख्या वाढत होती त्यामुळे उपचारासाठी बेड मिळणेही खूप मुश्किल झालं होतं.

नव्याने सुरु केलेले के के हॉस्पिटल कोरोना सेंटर हे त्या तरुण रुग्णासाठी एक जीवनदायिनीच ठरलं.
हॉस्पिटल मध्ये दाखल होताच लगेच उपचाराला सुरुवात करण्यात आली.सुरुवातीपासूनच व्हेंटिलेटरची आणि ऑक्सिजन ची गरज लागली नाही .त्यामुळे घरचेही आणि नातेवाईकही खूप घाबरलेल्या अवस्थेत होते.पण डॉ. नितेश खैरे ह्यांनी मला धीर दिला आणि मानसिक तयारी करून घेतली.तब्बल ८ दिवस उपचार सुरु होते.के के हॉस्पिटल स्टाफने सुद्धा अगदी वेळेत काळजी घेत रुग्णाला ह्या आजारातून मुक्त केले आहे.

के के हॉस्पिटल मध्ये मिळलेल्या सेवेबद्दल रुग्णाने व नातेवाईकांनी हॉस्पिटलचे मनापासून आभार मानले आहेत.

संध्याकाळ होते आणि पिल्लांसाठी चारा शोधायला दूरवर गेलेली पाखरे घराकडे धाव घेतात. पाखरेच काय माणसांचेही तसेच आहे. घर कितीही दूर असो.. रस्त्याने कितीही गर्दी असो.. लोकलमध्ये कितीही जीव गुदमरो पण त्याची पर्वा नसते. संध्याकाळी पाऊले नकळत वळतात ती घराकडेच.तसं हा रुग्ण डिस्चार्ज घेऊन घराकडे जाताना अगदी आनंदी होता.

कितीही संकट आलं तरी आपली इच्छाशक्ती आणि सकारात्मक विचार आपल्याला संकटातून बाहेर काढू शकतात ह्याचे उत्तम उदाहरण म्हणजे आज डिस्चार्ज झालेला रुग्ण.

!! नियम पाळा, सुरक्षित रहा !! येशवंत सिताराम संकपाल मो.९८२३०१५४९०

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