OCULAR SYMPTOMS IN POST COVID-19 PATIENTS: A TWO YEAR FOLLOW-UP STUDY

Published 2025 - 29th ESCRS Winter Meeting

Reference: PO077 | Type: Presented Poster & Poster | DOI: 10.82333/rfgm-z731

Authors: Andreas Guttmann* ¹ , Nora Woltsche ¹ , Astrid Heidinger ¹ , Paul Wintersteller ¹ , Karin Pekovits ¹ , Nika Medic ¹ , Ingrid Boldin ¹ , Haleh Aminfar ¹ , Gernot Steinwender ¹ , Julia Aschauer ² , Bernadette Matijak-Kronschachner ¹ , Gerold Schwantzer ³ , Jutta Horwath-Winter ¹

¹Ophthalmology,Medical University Graz,Graz,Austria, ²Ophthalmology,Medical University of Vienna,Vienna,Austria, ³Institute for Medical Informatics, Statistics and Documentation,Medical University Graz,Graz,Austria

Purpose

This study aims to investigate the long-term effects of SARS-CoV-2 infection during the first pandemic wave, particularly in patients with a history of hospitalization, by examining the tear film, ocular surface, and morphology of meibomian glands and corneal nerves in patients with and without new-onset ocular symptoms

Setting

Dry Eye Unit of the Department of Ophthalmology at the Medical University of Graz, Austria

Methods

This prospective cohort study included 13 patients in the COVID-19 Related Ocular Symptom Group (COSG) and 13 age- and sex-matched controls in the COVID-19 Without Ocular Symptoms (CWOS) group, drawn from a cohort of hospitalized COVID-19 patients from the first pandemic wave. Ocular assessments included Keratograph 5M for non-contact meibography, tear film stability and bulbar redness, LipiView® interferometry for lipid layer thickness, Schirmer test, Cochet-Bonnet esthesiometry, corneal fluorescein staining and in vivo confocal microscopy (IVCM) to evaluate corneal nerve alterations, dendritic cell presence, and microneuromas. Symptom severity was rated using the Ocular Surface Disease Index (OSDI), Face Score, and Visual Analog Scale (VAS).

Results

Dry Eye parameter results were not statistically significant between the groups. However, COSG patients showed trends toward higher NEI and VAS scores, increased lipid layer thickness, and greater meibomian gland dropout, particularly in the lower eyelid. IVCM findings indicated a higher prevalence of corneal dendritic cells and microneuromas in the COSG, though without statistical significance between groups; both COSG and CWOS exhibited pathological alterations in corneal nerves and showed differences compared to healthy controls reported in other studies. Additionally, 43.8% of COSG patients reported no symptom relief following Oxybuprocaine 0.4% eye drop administration, suggesting potential neuropathic corneal pain (NCP).

Conclusion

Two years after severe COVID-19 infection, patients demonstrate ongoing corneal inflammation, structural nerve changes, and signs consistent with neuropathic pain, even without ocular symptoms, underscoring the need for routine ocular evaluations in post-COVID-19 care to detect and manage long-term ocular consequences.