A study of ophthalmic co-morbidities in mild to moderate cases of COVID- 19 infection

Abstract

To study the ophthalmic co-morbidities and post- COVID ophthalmic complications in mild to moderate COVID positive patients. This was a questionnaire based prospective longitudinal study conducted between August 2020 and December 2020. In the first phase, an ophthalmologist in personal protective equipment (PPE) physically visited the patients and a pre-designed structured questionnaire regarding any ophthalmic complaints was filled and scoring was done later. In the second phase, the patients were telephonically interviewed after 3-6 months of their discharge from the hospital, regarding the development of ocular symptoms for which they needed to consult an ophthalmologist and the treatment taken was noted. 9% of the total 77 patients included in the study reported severe symptoms (scores between 17-24/24). On comparing the mean questionnaire scores (out of 24) it was seen that more severe ophthalmic complaints were seen in patients aged >= 50 years than <50 years (11.35 vs 5.75, p<0.05), moderate category than mild category patients (11.70 vs 3.63, p<0.05), patients with systemic co-morbidities than those who had none (11.48 vs 4.04, p<0.05) and in patients who later needed to consult an ophthalmologist due to development of one or more complications than those who did not.(13.27 vs 6.63, p<0.05).Post- COVID complications were seen in 27 patients (35%). They included progression of pre-existing ocular disease like cataract, glaucoma, diabetic and hypertensive retinopathy, and new diagnosis of diabetic and hypertensive retinopathy and HCQ- related maculopathy. Ocular co-morbidities should be looked for in every COVID patient. Those at higher risk of developing complications, should undergo a detailed ophthalmic examination after they are discharged from the isolation wards. Hospitals need to work on capacity building and/or look for alternatives, like telemedicine, to ensure timely eye care to all patients.