Hey Eyes and Shine, Dr. Allan here. So, have you noticed in the last few years,
your dry eyes have gotten worse? Well, it turns out that COVID-19 could be the reason
why. Recently, I had a viewer ask me if COVID was related to dry eyes, so I dug into the research,
and I found some surprising information that I did not know about. But first,
if you've ever had COVID or if you do get COVID in the future, COVID-19 can and does affect the eyes,
with meta-analyses showing about up to 30% of cases have some form of ocular involvement.
Even from the very early days of COVID, we've known that the virus can cause some
pretty serious cases of conjunctivitis or pink eye, which is by far the most common
symptom that people will have. Interestingly enough, it turns out that just having a case
of pink eye could be the only symptom that you have from a COVID infection,
not even anything else going on with the respiratory system or anything, just pink
eye. COVID has also been linked to more serious eye diseases within the eye, things like uveitis,
which is a severe inflammation of the eye, to an artery occlusion, which is having a stroke
within the eye, to various retinal diseases, and even inflammation of the optic nerve.
Myself, I have seen at least three cases of a rare retinal disease called acute macular
neuroretinopathy. This is so rare you're only supposed to see one case out of a million people,
and I've seen three cases within the last few years, all in young women
who had just recently been diagnosed with COVID-19. Unfortunately for those women,
they all have permanent spots in their vision now that probably will never recover. So,
if you ever do have any vision changes or something going on with the eye around the
time that you get a COVID infection, definitely contact a local eye doctor.
Okay, now with all of that aside, what about dry eyes? What are we now starting to understand and
find out with COVID and dry eye? Well, in a recent study, they looked at people who had
dry eyes before COVID, and then they analyzed those same people after a COVID-19 infection,
and they found that their dry eyes became way more severe. So, basically,
if you're someone who has noticed your dry eyes have gotten worse over the pandemic,
well, maybe COVID is to blame. But what I found interesting in this study was how the dry eyes
got worse. They reported a severe reduction in the lipid layer thickness, along with worsening
Meibomian gland dysfunction and dropout of the Meibomian glands on the eyelids, and worsening
signs of PIL, which is kind of an inflammatory marker on the inner lining of the eyelids.
Now, again, this information I thought was interesting but not really surprising just
yet because all those sort of findings, honestly, we see in the majority of people who do have dry
eyes. But what I thought was truly surprising was what the authors put in their conclusion
about why they thought COVID was making dry eyes worse. In their conclusion, they reported that
the SARS-CoV-2 virus can bind to the ACE2 receptor of the host cell, which happens to be found in the
Meibomian glands, leading to gland dysfunction. So basically, they hypothesize that the COVID
virus can bind to the Meibomian glands and cause dysfunction, which can lead to further dropout and
atrophy of those gland hands, which means you don't produce as much oil for your tear film,
and then your tear film evaporates much quicker, leading to more severe dry eye.
And in addition to this, they also mentioned higher levels of inflammation in the ocular
tissues because of the COVID virus. And we know from previous videos that we've talked
about the Vicious Cycle of dry eye includes inflammation kind of acting like gasoline
throwing onto a fire. And in the study, they also briefly mentioned how COVID may interrupt
the microbiome of the eyelids and the tear film itself because COVID has been found
in the tears of people with an infection. And then finally, they speculate that because COVID
can disrupt the gut microbiome, that dry eyes may get worse because of that gut dysbiosis.
All of this is super interesting. I never knew that COVID could possibly be linked to worsening
Meibomian gland dysfunction. It's always a good day when you learn something new. One
thing that I thought of that wasn't mentioned in their conclusions was that during the pandemic,
especially during lockdown, everybody was indoors and spent a lot more time in front of digital
screens like their computer or their phone. And we know that when we stare at our digital screens,
we don't blink as often, and our tear film is more likely to evaporate. And perhaps that may
play a role in worsening severity of dry eyes as well. Either way, though, still a very interesting
study, and I will put a link to it in the description below if you want to read it yourself.
Hey, I just want to take a second pulling back from editing this video and kind of
make sure something's very clear that all of this information regarding COVID-19, dry eyes,
and other forms of eye conditions related to COVID-19 infections is all still very new
information. And even with these few publications on dry eye getting worse related to COVID,
I think it's impossible with just a few publications that eye doctors would be
able to specifically blame COVID for anybody's dry eye getting worse. I think it's likely,
it makes sense, but again, even if you were to come into the clinic, it would be impossible for
someone like me to look at somebody's eye and be like, 'Ah, this is all due to COVID.' Again,
we just don't have that data and that proof of information. Either way, though, still very
interesting, and as I said, I'll put links to all my resources in the description below for anybody
who wants to read a little bit further. Otherwise, let's get into the last little section here.
Okay, so what if you've had COVID and you have dry eyes? What can you do from here? Well,
first of all, definitely contact a local eye doctor or a dry eye specialist if you can locate
one in your area. That way, they can at least examine and make sure everything's doing okay,
and they can give you proper guidance of what medications and treatments will probably work
the best for you. I think because our knowledge is that there is a lot of inflammation associated
with COVID that can affect the whole body but definitely even on the eyes,
that likely some form of anti-inflammatory would probably help. Something like either
a topical steroid or maybe like a cyclosporin option.
I know for one patient of mine that did have very severe dry eye after coming out of a
medically induced coma related to COVID, it took a long journey for that one patient. But
they did have to go through several rounds of either topical steroids and eventually
getting onto a medication called Cequa, which is a brand-named kind of souped-up version of
Restasis that works a bit faster. Ultimately, after several weeks and months of treatment,
things did get better under control, and she was able to go back to wearing contacts,
which was a huge victory because that was her real main goal. She just wanted to wear contacts again.
Now, if you do have Meibomian gland dysfunction or MGD, and about 86% of people with dry eye do
have some form of MGD, then there are several treatments for that, some even which you can
do at home. But I'll put links to kind of other videos we've done on MGD and different treatment
options for dry eye again in the description below. Hit that like button for you. And finally,
if you know that your diet could be better and you want to look more into how the gut
microbiome and diet affect dry eyes, we have done some great live stream education
where we did kind of a deeper dive into those topics. And I'll put links to those videos up
over here to the side so you can check those out and learn a little bit more. Otherwise,
again Dr. Allen here from Dr. Eye Health, thanks for watching and hope you have a
fantastic day day