Abstract
Purpose :
It has been theorized that there is an association between the novel coronavirus COVID-19 and glaucoma. This study was performed to investigate the relationship between COVID-19 and glaucoma and identify patterns in the manifestation and inciting factors of the eye disease.
Methods :
A PubMed search of MeSH terms including COVID-19 and glaucoma identified 11 case studies from an initial result of 28 when limited to results of patients with glaucoma diagnosis and COVID-19. This excluded vaccine-related events. These studies were reviewed, data including intraocular pressure measurements, patient age, time from diagnosis of COVID-19 to the onset of ocular symptoms, and other metrics were analyzed.
Results :
Patient Demographics
Patient age was mean 56 with a range of 43 to 66, including seven female patients, and four male patients. Six cases had no prior ocular history, two were described as having prior glaucoma, one had diabetes, and two had hypertension. Eight cases of acute angle closure glaucoma were diagnosed, with five of these cases being unilateral. There was additionally one case of neovascular glaucoma, and two cases of uveitic glaucoma.
Symptoms
The most common presenting symptom overall was vision changes. When presenting for COVID-19 first, the most common symptom was fever. Typical symptoms of viral infection were not present in all patients who presented with primary ocular symptoms.
Timing
The onset of ocular symptoms following diagnosis of COVID-19 infection ranged from 0 to 43 days. In four cases, ocular symptoms manifested before the COVID-19 diagnosis. In seven cases, COVID-19 symptoms were present before the onset of ocular symptoms, and it took an average of 15 days for ocular symptoms to manifest.
Glaucoma Inciting Factors
Factors linking COVID-19 infection and glaucoma included bilateral acute iris de-pigmentation leading to trabecular meshwork obstruction, hyponatremia, anterior uveitis, prone positioning during hospitalization for COVID-19, COVID-19-related medications, and retinal ischemia leading to neovascularization
Conclusions :
There may be a relationship between COVID-19 and glaucoma. Future studies should include a retrospective review to determine the relative risk of glaucoma in COVID-19-infected patients, as well as to be on the lookout for ocular manifestations of the disease in settings where patients are unable to express changes in their vision.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.