Episcleritis and sub-conjunctival haemorrhage in Post- acute COVID-19 patients - A case series

The research on COVID-19 is mainly focused on the respiratory system for survival rate improvement. In recent days, the affect of the disease on other organs including eye has been reported.However, a lot of research and data is needed to understand the pathophysiology and develop effective treatment strategies. In the present study, we report a series of 8 patients who presented themselves in the hospital with complaints of redness in the eye. All these patients had a history of COVID-19 illness during preceding one month. Patients were diagnosed with epislecritis and/or sub-conjunctival haemorrhage using clinical evaluation. They were put on topical steriods and ganciclovir. All the patients improved/recovered within 10 days of presentation. Our study reports the ocular manifestations- episcleritis and sub-conjunctival haemorrhage as Post-acute COVID-19 symptom in cases of lab positive and symptomatic mild COVID-19 disease. These ocular manifestations have been otherwise reported during acute phase or as one of the early signs of infections. Mild cases of COVID-19 presented themselves with episcelritis and/or sub-conjunctival haemorrhage after acute phase (3- 4 weeks after commencement of infections). This highlights that SARS-COV-2 leads to hemorrhagic and inflammatory response in the eyes as a sequelae, well beyond the period when replication-competent SARS-CoV-2 have not been isolated.