Topic outline

  • Grand Rounds

    A 33-year-old female presented with 6 days of eye redness and tearing without vision changes. She had no significant past medical history and was not taking any medications. Of note, the patient was a Registered Nurse at University of Miami Hospital. She had multiple confirmed COVID exposures prior to ocular symptom onset and underwent a nasopharyngeal COVID-19 swab with results still pending at the time or presentation. She had no other systemic symptoms of coronavirus. The patient was seen and examined in the negative pressure tent at Bascom Palmer Eye Institute. Her visual acuity was 20/20 OU when measured on a near card. Her intraocular pressure was recorded as soft to palpation OU. Her pupils and extraocular movements were normal.

    On portable slit lamp exam, the patient was found to have 2+ conjunctival injection, most prominent in the inferior conjunctiva, with follicles on the inferior palpebral conjunctiva. The cornea was clear, anterior chamber was deep, and the iris was round and flat. The patient was observed with conservative management only (cool compresses and artificial tears). She was told to self-isolate for 14 days. She noted improvement in symptoms in the following 1-2 days (she sent in photographs to her physician care team confirming improvement in conjunctival injection). The patient’s swab was ultimately negative, though clinical suspicion remained high. The patient’s follow up is documented through external photos along with a discussion of COVID-19 and its global impact, treatment options, ophthalmic manifestations, and the screening protocol at Bascom Palmer Eye Institute.

    Presentation Date: 04/23/2020
    Issue Date: 08/01/2020