Purpose: to study ocular manifestations in acute COVID-19 patients with severe or extremely severe course. Materials and methods. 112 patients with severe and extremely severe course ofCOVID-19 treated in the 2nd Zangiota specialized clinic for Covid patients underwent an ophthalmic examination. Results. Hyperemia of palpebral edges was found in 20 patients (17.8 %), tarsal conjunctiva hyperemia was found in 54 patients (48.2 %), whereas 11 patients (9.8 %) had symptoms of eyeball conjunctiva hyperemia. 27 patients (24.1 %), complained of pain in the projection of external muscle tendons attachments during eyeball palpitation. Retinal angiopathy of varied genesis were found in 57 patients (50.9 %). Blurred edges of the optic nerve and smoothness of physiological excavation were observed in 11 patients (9.8 %). We were able to trace the medical history of 25patents over two months after the discharge. Ofthese, 17 patients (68 %) visited an ophthalmologist and were diagnosed with dry eye syndrome, and 1 patient was diagnosed with uveitis. 4 patients complained of blurred vision, disorientation and memory loss. 1 patient was found to have episcleritis. 3 patients (12%) complained of a dramatic decrease of vision in one eye, ptosis, swollen eyelid and exophthalmos. They were diagnosed with thrombosis of the cavernous sinus and superior orbital fissure syndrome. Conclusion. The main ophthalmic symptoms of the anterior segment of the eye in patients in the acute stage of COVID-19 with severe and extremely severe courses were manifestations of dry eye syndrome, short-term manifestation of tenonitis of oculomotor muscles. In 50 % cases, angiopathy of the anterior and the posterior segments of the eyeball were observed. Severe manifestations of general coagulopathy and angiopathy developing superior orbitalfissure syndrome were observed in 12 patients within weeks after the patient's dischargefrom the clinic.