COV Eye D

Dr. Jarryd Willis PhD
7 min readJan 31, 2021

COVID19 has been detected “in ocular swabs indicating the presence of virus in the eye as long as 27 days after initial symptoms, even with concomitant absence of virus in nasal swabs (Colavita et al., 2020).”

#WearGlasses

Eyes & Ocular Entry

Veena Danthuluri & Maria Grant (2020)

“There is a benefit to using eye protection for healthcare workers and the general public and studies suggest that the lack of eye protection when other precautions are taken can result in contraction of the viral disease.”

“Angiotensin converting enzyme 2 (ACE2) serves as the receptor for the virus and is found in the eye, suggesting that the virus may be transmittable via tears (Willcox et al., 2020). The molecular mechanism of ACE2-driven infection and the time course of eye involvement, among children and adults, were the focus of this review with the intent that informed clinicians will not miss the diagnoses of COVID-19. While the ocular manifestations of COVID-19 have been considered minimal, there exist considerable data to support the importance of ocular findings (Wu et al., 2020).”

Danthuluri, V., & Grant, M. B. (2020). Update and Recommendations for Ocular Manifestations of COVID-19 in Adults and Children: A Narrative Review. Ophthalmology and Therapy, 1–23. https://doi.org/10.1007/s40123-020-00310-5

Supplemental Material: https://doi.org/10.6084/m9.figshare.13013984

Eyes

Zhou et al., 2020

…ocular surface cells including conjunctiva are susceptible to infection by SARS-CoV-2, and could therefore serve as a portal of entry… through exposure to respiratory droplets or hand-eye contact. This highlights the importance of safety practices including face masks and ocular contact precautions in preventing the spread of COVID-19 disease.”

COVID19 has been detected “in ocular swabs indicating the presence of virus in the eye as long as 27 days after initial symptoms, even with concomitant absence of virus in nasal swabs (Colavita et al., 2020).”

Although viral infection of ocular cells has not yet been reported in patients, a recent report found SARS-CoV-2 can infect conjunctiva in an ex-vivo culture system (Hui et al., 2020). Our results may offer additional insights regarding the role of the ocular surface in COVID-19 transmission, suggesting that the ocular surface may serve as a significant reservoir for virus.”

Contact Lens & Eyes: Risk of Ocular COVID19 Infection

Marta Vianya-Estopa et al., 2020

Thankfully, “56% of participants reported using their lenses less during the COVID pandemic.”

Bakkar & Alzghoul, 2021 (90.8% women)

Thankfully, “38.8 % of the study population reported stopping CL wear during the pandemic. The main stated reason for lens discontinuation was decreased social activities during the pandemic.”

90.8% women → “61.2 % of participants continued lens wear, with the majority reported considerable changes in their behaviors toward CL wear and care during the pandemic. This includes reinforced hands cleaning before and after lens wear (90.8% women), disinfecting of CLs and CL case and less frequent CL aftercare visits.”

Jarryd: Given what we know about men’s handwashing agnosticism, the fact that this sample was ~91% women should be taken into consideration. Excellent research — love the study — just think the XX/Xy breakdown is relevant to keep in mind.

“Contact lens wearers reported profound changes in attitudes toward CL wear including improved care and maintenance. Additionally, changes in CL purchase habit have been reported with more tendency for online purchase. CL cessation has been associated with several perceived reasons mainly attributed to reduced outdoor activity and fear of ocular infection.”

Eyes

Feng et al., 2021

“The eye has been identified as a potential route of entry and site of disease manifestation. Thus, ocular protection has been recommended and implemented in various health care settings. …current evidence suggests the potential for ocular transmission via 2 mechanisms: viral binding to the ocular surface via the ACE2 receptor and viral dissemination through the tear film and into the upper respiratory tract.”

Feng, Y., Armenti, S. T., & Mian, S. I. (2021). COVID-19 and the Eye: A Comprehensive Review of the Literature. International Ophthalmology Clinics, 61(1), 1–14.

Eyes

Khunti et al., 2020

“Indirect evidence suggests that healthcare workers’ conjunctivae could be exposed to infective droplets and aerosols from patients during close contact.”

Khunti, K., Greenhalgh, T., & Chan, X. H. (2020). What is the efficacy of eye protection equipment compared to no eye protection equipment in preventing transmission of COVID-19-type respiratory illnesses in primary and community care?. CEBM.

Willcox et al., 2020 (p. 419): “All viruses need to bind (adhere) to host cells, as the first step in their invasion of cells and subsequent replication. Coronaviruses use the spike protein that protrudes through their lipid envelope to bind to various receptors on host cells (Fehr & Perlman, 2015). SARS-CoV-2 uses angiotensin converting enzyme-2 (ACE2) as its receptor on human cells, and binding to this facilitates infection (Yan et al., 2020).”

“Given the need for contact lens wearers to touch their face and eyes on application and removal of their contact lenses, it is understandable that questions have been raised about the safety of continuing with contact lens use during the pandemic (Jones et al., 2020)”

“Consistent with guidance for other types of illness, particularly those of the respiratory tract, no contact lens wearer with active COVID-19 should remain wearing their contact lenses (Sankaridurg et al., 2004; Sweeney et al., 2004; Willcox et al., 2004). This is the time to cease contact lens wear and revert to spectacles.”
— Jones et al., 2020

Jones, L., Walsh, K., Willcox, M., Morgan, P., & Nichols, J. (2020). The COVID-19 pandemic: Important considerations for contact lens practitioners. Contact Lens and Anterior Eye, 43(3), 196–203.

Willcox, M. D., Walsh, K., Nichols, J. J., Morgan, P. B., & Jones, L. W. (2020). The ocular surface, coronaviruses and COVID‐19. Clinical and Experimental Optometry, 103(4), 418–424.

Eyes & #COVIDー19

1. Many #UCSD students switched from CLens to glasses in 2020.

2. Bakkar & Alzghoul (2021) reported that 38.8% of subjects stopped wearing CL.

3. Marta Vianya-Estopa et al. (2020) reported a 56% decrease in wearing CL.

Reminder…

“if someone becomes infected while wearing a mask, they are more likely to have a milder or asymptomatic infection than someone who becomes infected while not wearing a mask” (Gandhi & Marr, 2020)

Sidenotes

As toddlers, males make less eye contact — that is, as compared to females (Freedman, 2003).

In childhood, females make direct eye contact at an earlier age and for a longer period of time than males (Irenäus Eibl-Eibesfelt, 1982; Montoya et al., 2018). Girls are more likely to play with toys that have faces (eye contact) whereas boys are more likely to rip the heads off such toys.

As they says, boys will be bo… held responsible for their actions.

The Recursive Loop

- “The coming year could be a story of two worlds undermining each other. Certain countries will approach herd immunity by vaccinating almost every citizen. Other countries could see mass casualties and catastrophic waves of reinfection — potentially with variants that evolved in response to the immunity conferred by the very vaccines to which these populations do not have access. In the process, these hot spots themselves will facilitate rapid evolution, giving rise to even more variants that could make the vaccinated populations susceptible to disease once again.

In a recursive loop, the virus could come back to haunt the vaccinated, leading to new surges and lockdowns in coming years. The countries that hoard the vaccine without a plan to help others do so at their own peril.” (James Hamblin, MD, The Atlantic)

As terrifying as that sounds, it’s highly unlikely as long as the countries who receive the initial vaccines aren’t highly individualistic.

The Uncanny Gaze

The amygdala responds more strongly to direct gaze than to averted gaze (Kawashima et al., 1999), particularly when processing sex/gender (Macrae et al., 2002), and even if the mutual eye gaze is with a soulless robot as opposed to a fellow soulborne human (Kiilavuori et al., 2021). We respond more strongly to a robot looking directly at us compared to a robot looking at someone else (Imai et al., 2002), and this is associated with perceptions of robots’ intentions & social engagement (Kompatsiari et al., 2019, 2021).

Ultimately, we’re more responsive to direct gaze from fellow soulborne humans than soulless robots (virtual/cpu; Katsyri et al., 2020) or cartoon faces (James et al., 2015).

If we’re uncertain about someone’s gaze, we assume it’s direct (Mareschal et al., 2014; Nummenmaa & Calder, 2008) — from an evolutionary standpoint, a false positive regarding someone’s gaze would be associated with survival moreso than a false negative.

3.6.2021 Update

#Gamers looking for non-prescription eye protection against #COViD19 ocular infection should consider @zennioptical — You can buy wide glasses for when you go out & gaming glasses to reduce #BlueLight & any eye strain.

https://zennioptical.com/gaming-glasses #ArmorYourEyes

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Dr. Jarryd Willis PhD

I'm passionate about making a tangible difference in the lives of others, & that's something I have the opportunity to do a professor & researcher.