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LETTER TO THE EDITOR
Year : 2021  |  Volume : 69  |  Issue : 1  |  Page : 165

Comments on: Clinical profile and prevalence of conjunctivitis in mild COVID-19 patients in a tertiary care COVID-19 hospital: A retrospective cross-sectional study


1 Consultant Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Thavalukuppam, Pondicherry, India
2 Pediatric and Squint Fellow, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Cuddalore Main Road, Thavalukuppam, Pondicherry, India

Date of Web Publication15-Dec-2020

Correspondence Address:
Dr. Kirandeep Kaur
Pediatric and Squint Fellow, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Cuddalore Main Road, Thavalukuppam, Pondicherry - 605 007
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2571_20

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How to cite this article:
Gurnani B, Kaur K. Comments on: Clinical profile and prevalence of conjunctivitis in mild COVID-19 patients in a tertiary care COVID-19 hospital: A retrospective cross-sectional study. Indian J Ophthalmol 2021;69:165

How to cite this URL:
Gurnani B, Kaur K. Comments on: Clinical profile and prevalence of conjunctivitis in mild COVID-19 patients in a tertiary care COVID-19 hospital: A retrospective cross-sectional study. Indian J Ophthalmol [serial online] 2021 [cited 2021 Jan 21];69:165. Available from: https://www.ijo.in/text.asp?2021/69/1/165/303311



Dear Editor,

Recently published literature has shown that the coronavirus disease (COVID-19) can cause ocular complications such as conjunctivitis, though not necessarily in the early stages of the disease.[1] Chen et al.[2] showed that conjunctival congestion is one of the COVID-19-related ocular symptoms, which may have clinical diagnostic significance. We read the article by Sindhuja et al.[3] with great interest and we must congratulate the authors for bringing out this interesting COVID-19 clinical study, probably the first large scale conjunctivitis retrospective analysis in India.

However, we have a few important observations to make and would like the authors to throw light on that. Firstly, the authors have highlighted that patient details were extracted from predesigned proforma. Is this perfoma being regularly used for all COVID-19 positive admitted patients as a routine protocol or was specifically designed for this conjunctivitis study? If the perfoma was specifically designed for this study, then this highlights the prospective nature of the study, but the study mentions it as a retrospective analysis. This needs clarification.

Secondly, the authors have mentioned that 12/127 had ocular complaints. Did the ophthalmologist posted in the ward for rounds also examined the remaining 115 asymptomatic patients? This is not clear in the methodology. If not, then there is a possibility that few of the patients with mild conjunctivitis may have been missed and this stands as a limitation.

Lastly, the authors have mentioned that 8/11 had conjunctival congestion. Since none of the patients had any associated signs and symptoms of conjunctivitis such as discharge, chemosis,[3] pain, and periorbital edema, how did the authors rule out other causes of diffuse conjunctival congestion such as episcleritis, scleritis, dry eyes, and congestion due to inadequate sleep or stress on torchlight examination?

Moreover, the occurrence of conjunctivitis along with the COVID-19 symptoms can be a chance association as levels of severe acute respiratory syndrome coronavirus 2 (SARS COVID-19) was not assessed by conjunctival swab analysis.[4],[5]

Acknowledgments

Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Amesty MA, Alio del Barrio JL, Alio JL. COVID-19 disease and ophthalmology: An update. Ophthalmol Ther 2020;9:1-12.  Back to cited text no. 1
    
2.
Chen L, Deng C, Chen X, Zhang X, Chen B, Yu H, et al. Ocular manifestations and clinical characteristics of 534 cases of COVID-19 in China: A cross sectional study. medRxiv 2020.  Back to cited text no. 2
    
3.
Sindhuja K, Lomi N, Asif MI, Tandon R. Clinical profile and prevalence of conjunctivitis in mild COVID-19 patients in a tertiary care COVID-19 hospital: A retrospective cross-sectional study. Indian J Ophthalmol 2020;68:1546-50.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Joseph J. Commentary: Exploring the transmission of COVID-19 through the ocular surface. Indian J Ophthalmol 2020;68:1018-9.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Xie HT, Jiang SY, Xu KK, Liu X, Xu B, Wang L, Zhang MC. SARS-CoV-2 in the ocular surface of COVID-19 patients. Eye Vis (Lond). 2020;7:23.  Back to cited text no. 5
    




 

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