Ask An Eye Doctor: COVID-19 Edition

With most optometry offices closing temporarily due to COVID-19, our co-founder, Dr. Kaleb Abbott answered your eye and vision questions via social media. Here are the answers! If you have any other questions, reach out to Dr. Abbott at kaleb@sunsnapkids.com or reach out via social media @sunsnapkids 🤓

Can COVID-19 cause any eye problems? 

As many as 30% of persons with COVID-19 will experience viral conjunctivitis and eye irritation.^[1] The white part of the eye (sclera) will appear pink in color and the eye may experience some discomfort and irritation. Cases of this appear to be fairly self-limiting and do not require intervention or treatment. Having said that, many many things cause the eye to turn pink in color. If your eye turns pink and you do not have other tell-tale symptoms of COVID-19, it is still highly unlikely your eye discoloration is occurring due to COVID-19. Pay more attention to other symptoms (cough, shortness of breath, fever, potential GI disturbances, etc) if you believe you may have contracted COVID-19 -- pink eye is not a necessary nor sufficient sign to suspect COVID-19. COVID-19 does not cause vision loss or permanent ocular damage. 

During COVID-19, is it safe to keep wearing my contact lenses, especially when in public like going to the grocery store?

COVID-19 is known to spread through mucous membranes (including the eyes). This is why frontline medical workers are wearing eye protection. Additionally, COVID-19 is one of the rare pathogens which can also spread through the tears.^[2] 

Based on this information, wearing glasses is safer than wearing contact lenses during this time, especially when in public places, because the glasses can act as a physical barrier between virus particles and your eye's mucous membranes. Be sure to clean your glasses though after returning home from a public place! Glasses can be cleaned with soap and water, sanitizing wipes, or hand sanitizer. 

If you must wear contact lenses during this time, it is best to not wear them in public places. Also, your hands and face need to be VERY clean when inserting and removing the lenses. Now more than ever, contact lens hygiene is extremely important. Also, sharing of contact lenses between persons is never advisable, and is even more risky at this time. 

Again, wearing glasses is the safest method of vision correction for at least the next few months.

My eye clinic is closed due to COVID-19 -- how can I get more contact lenses or another pair of glasses if mine broke?

With the COVID-19 crisis and routine eye examinations being largely cancelled, many optometrists are extending contact lens prescriptions by 3 months so their patients can order their previous contact lens brand and power. If your vision is fine with your current contacts, you should ask your regular optometrist if he/she would be willing to extend your prescription a few months until you can be seen for your annual exam.

During COVID0-19, is it safe to go outside and walk or ride a bike if you stay 6 feet or greater from other people? I'm just concerned that the virus could blow in my eyes from 100s of feet away. Do my fears have merit?

6 feet away is perfectly fine for light physical activities (such as walking). The CDC just made a new recommendation of staying further away with more intense physical activity though (such as running or riding a bike) as heavier breathing could cause the viral particles to travel further. Concerns about viral particles traveling hundreds of feet are unwarranted. Similar to all matter, viral particles succumb to gravity and eventually fall to the ground. As long as social distancing is practiced and your city allows it, being outside is a great idea especially since physical activity is linked with a better immune system.

I have a 5 month old son. With summer coming, it's been getting brighter and brighter out on his evening walks. What is the best way to protect his eyes from the sun at this age? Also, he has blue eyes. Are blue eyes more sensitive to sunlight than brown eyes?

Congrats on the little one! Yes, blue eyes are definitely more sensitive to light than darker pigmented eyes. It is excellent that you are spending time outdoors with your son as time outdoors has been shown to be protective against kids developing myopia (nearsightedness). It is also excellent that you are concerned about protecting his eyes during this critical developmental period. There are some sunglasses specifically made for infants (ex. WeeFarers and Babiators), but infants sometimes do not like things on their faces. Click here  for more tips to protect your kid's eyes! And remember, infantSEE is a program that will give your infant (under 12 months of age) a free exam exam, you just may need to wait a few months until offices reopen. 

How many hours a day should I wear my contact lenses? I seem to go through my monthly contacts a lot sooner than monthly. I was wondering if it's because I wear them a lot.

How many hours a person can tolerate contact lenses (CL) depends on many factors (age, climate, CL brand, diet, etc). Some experienced CL wearers may only tolerate 8 hours of wear. The maximum number of hours CLs should be worn per day is 14-16 though. 

Longer wear time can definitely tire out a monthly lens sooner. However, CL brand also plays a big factor here. If you feel like you aren't getting a full month's use out of your monthly CLs, you may want to consider switching CL brands. When your optometry office re-opens, ask your optometrist if you can trial out several different monthly brands. You will likely find a brand you prefer more. Make sure you are changing out your CL solution daily and not over-cleaning (over-rubbing) the CLs too as that can wear out the lens quicker.

My four year old is dealing with some crazy allergies and complaining that her eyes itch. What OTC medication do you recommend?

I'm sorry to hear that, allergies are no fun. My go-to OTC allergy eyedrop is Zaditor. My next favorite is Alaway. 1 drop should be instilled 1-2x/day when symptomatic. Refrigerating these drops is also helpful. 

Interestingly, a prescription allergy eyedrop called Pataday was just approved to be OTC about 2 months ago. So if Zaditor or Alaway don't work, try Pataday as it is a bit stronger.

Sources:

[1] 'Pink Eye' Often a Symptom of COVID-19, and Infection Via Tears Possible, https://www.webmd.com/lung/news/20200401/pink-eye-often-a-symptom-of-covid-19#1

[2] Wu P, Duan F, Luo C, et al. Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei province, China [published online March 31, 2020]. JAMA Ophthalmol. doi: 10.1001/jamaophthalmol.2020.1291.