Healthcare workers urged not to ‘forget the eyes' in care of Covid-19 patients

Fight for Sight’s Research Fellow is calling for eye care to be included in the care of patients who are critically ill with Covid-19 to stop them losing their sight, in a letter published in Eye on 12 May.

Clinical Research Fellow Dr Darren S J Ting from the University of Nottingham specialises in corneal infection and has published a summary of eye care for those looking after patients in intensive care units.

Corneal infection, which can cause blindness, and other ocular complications have been a recurring theme for critically ill patients in ICUs, as a result of patients’ inability to close their eyes causing exposure keratopathy, trouble blinking, dry eyes and contamination from the infected respiratory secretions, among other issues. In addition, Covid-19 patients who require critical care are usually those who are elderly with multiple co-morbidities, and elderly patients are known to experience poorer visual outcome and a higher rate of complications if corneal infection develops.

Dr Ting and the team (led by Professor Harminder Dua) describe how this issue recently came to light when a patient with COVID-19 in the intensive care unit who had been on a ventilator for several days, developed an exposure keratopathy (damage to the cornea). The patient was immediately examined and treated by the ophthalmology team.

Dr Ting said: “This incident underscores the importance of incorporating prevention, recognition, and management of eye problems as part of the care bundle of COVID-19. It would be an unimaginable tragedy for patients with COVID-19 to recover from the life-threatening respiratory illness but to wake up with vision loss.”

Chief Executive of Fight for Sight, Sherine Krause said: “We know what a massive impact sight loss can have on people's lives - hugely impeding independence, livelihoods and mental health - so Dr Ting’s advice for including eye care as part of treatment for those with Covid-19 in intensive care is really important to ensure the very best outcome for patients in the long-term.”

Dr Ting is jointly funded by Fight for Sight and the Medical Research Council (MRC).