May Kravitz, of New York City, thought she was recovering from COVID-19 after experiencing only mild symptoms of the infection for a few weeks in late February. It wasn’t long, however, before she began to experience a new, unexpected symptom: persistent eye pain.
“I actually cried about something. I was having a conversation with a dear friend of mine and I thought that I [was] having pain and headache from crying because usually that’s what happens,” Kravitz told ABC News.
Kravitz became ill with COVID-19 around the same time as her friends, and she believes they caught it at the same dinner party. She said that eventually they all began to experience similar eye pain. The pain was severe enough that it prompted her to call Dr. Jeffrey Dello Russo, an ophthalmologic surgeon in New York City.
“I said, ‘Listen, I have something really weird going on. My eyeballs feel like they're about to explode and I can’t move my eyes up and down onto the sides,’” said Kravitz
After they met virtually, Dello Russo referred Kravitz to New York Eye and Ear for an evaluation. He first thought Kravitz’s eye pain could be an early sign of multiple sclerosis, but realized later her pain could be from COVID-19.
With many people around the U.S. wearing masks, but not goggles or other eye-protective gear, throughout the pandemic, Dello Russo said that the eyes might be an overlooked way in which some people contract COVID-19.
“The whites of people's eyes is a mucous membrane, just like you have in your mouth [and] nose,” Dello Russo said.
The Centers for Disease Control and Prevention currently lists a number of common symptoms for COVID-19, but the majority of them are related to respiratory issues and fever, with no mention of eye issues. Although, the World Health Organization does list conjunctivitis as a “less common symptom” of the virus.
Although eye pain has not been identified as a common symptom of COVID-19, researchers are still continuing to learn more about the virus.
“We know that a range of symptoms can occur with COVID. It's not necessarily just shortness of breath and fever, especially with milder conditions,” said Dr. John Brownstein, an epidemiologist and ABC News contributor.
A small case study published in JAMA Ophthalmology in March 2020 found that 12 of the 38 COVID-19 patients examined reported eye-related symptoms. In a slightly larger study of 129 people with severe COVID-19 published in Radiology last month, researchers found that 7% of patients presented with one or several nodules -- sites of inflammation -- on their eyes.
Brownstein said that the severity and duration of eye-related conditions can vary just like symptoms of COVID-19 itself.
“The vast majority of patients recover within two weeks and so it's very short-lived. But just like the broad range of symptoms for COVID ... that can also happen when it comes to the ocular symptoms,” he said.
Along with eye pain, Kravitz said she also experienced other lasting symptoms, including fatigue.
“Anything I did required so much effort that I had to sleep for hours after,” said Kravitz. “It was very uncomfortable. I was nauseous and [had] headaches and muscle pain.”
Kravitz said that her eye pain has improved over time. But cases like hers have left Brownstein and Dello Russo wondering whether more eye screenings or protective measures for the eyes would help prevent the viral infection.
Brownstein said that vulnerable people may want to think about it.
“Thinking about eye-related protection, especially if you're in a high-risk category, makes sense or if you're in a high-risk environment where the likelihood of transmission is increased,” said Brownstein.
Currently, the CDC recommends that health care providers wear eye protection when meeting with patients, particularly in “areas with moderate to substantial community transmission.”
Dr. Anthony Fauci, the director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID) and the chief medical advisor to the president, suggested using protective gear for the eyes in July 2020 during an interview with ABC News.
"If you have goggles or an eye shield, you should use it,” he said in July 2020. “It's not universally recommended, but if you really want to be complete, you should probably use it if you can.”