The Sequelae of Bilateral Conjunctivitis as an Initial Presentation of Presumed COVID-19 Positive Female

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Danielle Piser
Carson Day
Jennifer S. Harthan, OD, FAAO, FSLS


Background and Objective
Presented is a case of a 28-year-old female, who was diagnosed with presumed COVID-19 (SARS-CoV-2) and the sequelae of her bilateral conjunctivitis. Since December 2019, the presence of severe acute respiratory syndrome COVID-19 has swept worldwide, infecting over 170 million to date and counting. It has been discovered that the virus can make its way to the eyes due to an abundance of human angiotensin-converting enzyme-2 on the conjunctiva. There are limited reports accounting for bilateral keratocon-junctivitis associated with SARS-CoV-2, and even less reporting as the initial symptom and the sequelae of the ocular findings that can be associated with a COVID-19 positive patient. In this report, the signs, symptoms, management, and treatment of COVID-19 related keratoconjunctivitis will be discussed.
Presented is a case of a 28-year-old female diagnosed with presumed COVID-19 and the sequelae of her bilateral conjunctivitis.
A 28-year-old female initially presented to her local emergency room on 7/9/2020 for bilateral red eyes and loss of taste and smell. She tested positive for COVID-19 at that time via a polymerase chain reaction nasopharyngeal swab. There was no conjunctival swab or serology testing of her tears performed. Her ocular symptoms persisted for an additional 3 weeks when she finally presented to our clinic, with bilateral keratoconjunctivitis, after testing negative for the virus 14 days prior.
This case presents findings of an initial presentation of bilateral conjunctivitis secondary to presumed COVID-19. The sequelae of the patient’s ocular findings after testing negative for COVID-19 were of specific interest. This case provides a resource to help guide eye care professionals in proper questioning of those diagnosed with COVID-19 about ocular symptoms they had initially, as well as symptoms that occurred after systemic resolution of the virus infection. Furthermore, this case can help educate eye care professionals on the possible sequalae, management, and treatment of COVID-19-related keratoconjunctivitis to ensure full resolution of its effect and provide a good visual outcome for patients. We will continue to learn more about COVID-19 and its effects on the eye as well as the effect of COVID-19 vaccines on ocular manifestations of the virus.


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Author Biographies

Danielle Piser, Illinois College of Optometry, Chicago, IL

Assistant Professor of Optometry; Chief, Alfred and Sarah Rosenbloom Center for Vision and Aging

Dr. Danielle Piser (Poole) received a Bachelor of Arts in biology from Mercyhurst University in 2003 and is a graduate of The Ohio State University College of Optometry (2007). She developed a passion for low vision and geriatric care and went on to complete her residency at the Illinois College of Optometry in low vision and ocular disease (2008).  Immediately following her residency, she became a clinical assistant professor at the Illinois College of Optometry. Dr. Piser has co-authored an article on stroke rehabilitation and has given continuing education lectures on urgent care, cataract surgery co-management, vision rehabilitation, geriatrics and contact lenses. As an active member of the American Academy of Optometry, she received her fellowship in 2009. She is also a member of the American Optometric Association, the Illinois Optometric Association, the Illinois Society for the Prevention of Blindness and the vision section of the American Public Health Association.

Dr. Piser currently works as a full-time faculty instructor at the Illinois Eye Institute and serves as Chief, in the Alfred and Sarah Rosenbloom Center for Vision and Aging. She concentrates in geriatric eye care, ocular disease and vision rehabilitation. She also manages patients with ophthalmology performing cataract pre-operative and post-operative examinations.

Carson Day, Cincinnati VA Medical Center, Cincinnati, OH

Resident at the Cincinnati VA

Jennifer S. Harthan, OD, FAAO, FSLS, Illinois College of Optometry, Chicago, IL

Dr. Harthan received her bachelor of science degree in biology from Bethel College in Minnesota in 2002 and her optometry degree from the Illinois College of Optometry in 2006. She completed a residency in cornea and contact lenses at ICO in 2007, joining the faculty after completion of her residency. Throughout her clinical experience, Dr. Harthan has also worked in private practice and hospital-based settings and continues to work in private practice part time. Dr. Harthan is currently an attending optometrist/full professor in the Cornea Center for Clinical Excellence of the Illinois Eye Institute. Dr. Harthan also is chief of the Cornea Center for Clinical Excellence of the Illinois Eye Institute where she works with both students and residents. She has received several awards for her clinical work and has presented numerous research projects/case reports at meetings throughout the year. Dr. Harthan is a Fellow of the American Academy of Optometry and actively involved with the American Optometric Association as a committee chair for the Contact Lens and Cornea Section. Dr. Harthan is experienced with a wide variety of contact lens fittings, including specialty lenses. Dr. Harthan is not only passionate about her career but also believes her patients deserve the best care.

Special Interests

Corneal diseases and contact lenses, urgent eye care, anterior segment disease


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