The recent rise in conjunctivitis cases is being attributed to a new Covid-19 strain. Is it true? South First speaks to doctors to find out.
Doctors agree that there is no known correlation between the increased conjunctivitis cases and the new Covid-19 variant. (Creative Commons)
Recent rise in cases of conjunctivitis, commonly known as “pink eye”, has sparked discussion amongst doctors about a possible link to a new variant of the Covid-19 virus. In the month of April in the US, there were reports of Arcturus, a subvariant of the highly contagious Omicron variant, showing symptoms of conjunctivitis, especially among children.
Dr M Madap Karuna, a paediatrician at Sandesh Clinic, and a few other doctors in Hyderabad, raised a question on the rampant spread of conjunctivitis case in Telangana and sought the government and ophthalmologists to conduct tests to know if the spread is due to any new variant of the Covid-19 virus.
However, medical experts South First spoke to affirm that the surge in pink eye cases is primarily related to the seasonal adenovirus and not a Covid-19 variant.
Viral conjunctivitis is a well-known condition that occurs during the monsoon season, especially in areas with hot weather and rain, leading to water stagnation and increased viral replication and spread. Adenovirus, colloquially known as “Madras eye infection”, is a respiratory virus that is prevalent during this period and is responsible for most cases of viral conjunctivitis.
The recent rise in viral conjunctivitis cases are being attributed to a new Covid-19 strain. (Creative Commons)
Dr Suhasini S, Consultant Ophthalmologist at MGM Healthcare in Chennai, told South First, “This phenomenon is usually noted at the beginning of the monsoons, especially when it is coupled with hot weather, water stagnation, etc, contributing to replication and spread.”
Though the viral conjunctivitis caused by Covid-19 is similar to any viral conjunctivitis, she said that they have not noticed a marked change in the epidemiology patterns, spread, and/or management practices.
Speaking to South First, Dr Nanditha Rathnam, Consultant Paediatrics and Paediatrics Intensive Care of Manipal Hospital in Yeshwanthpur, Bengaluru, said, “Most viruses are known to cause conjunctivitis. We are seeing a lot of children with pink eye, which is mostly due to other viruses and not Coivd variants at the moment in our unit.”
She explained that though there is no need to panic, considering the fact that Covid-19 symptoms keep changing with each variant, and the subvariant, Arcturus, which has been reported in multiple countries, has shown symptoms of pink eye in few cases.
“Though it is better to not dismiss common symptoms of cold, cough, and pink eye in children as simple viral infections or allergies, there is no need for parents to panic. The subvariant of Omicron is being monitored closely around the world and will be alerted definitely if there is any cause of concern.”
Gastroenterologist Dr Rajeev Jayadevan opined that conjunctivitis, an inflammation of the eyeball’s outer lining, is not a common occurrence in Covid-19 infections.
Different types of conjunctivitis. (Yashoda Hospital)
According to Dr Jayadevan, conjunctivitis is a common viral disease that affects a large number of people at any given time, independent of Covid-19 infections. During the recent Covid-19 wave, parallel occurrences of conjunctivitis, as well as mild redness of the eye that occurs with many viral fevers, might have been mistaken for Covid-19-related conjunctivitis.
In clinical practice, it is expensive and cumbersome to also check for the viral origin of conjunctivitis in a patient who comes to the OP primarily for mild symptoms of Covid.
The notion of a direct connection between conjunctivitis and Covid-19 appears to be a self-propagating myth lacking concrete evidence. Ophthalmologists, too, do not attribute conjunctivitis solely to Covid-19.
Regarding the eye as a transmission source, Dr Jayadevan clarified that although a tiny amount of aerosols (micro droplets suspended in the air), dispatched from people’s lungs, can theoretically stick to the conjunctiva of the eye, this does not mean the eye serves as a primary route of transmission for the virus.
While tears containing such viruses from the eye may drain into the nose, tears also possess natural antimicrobial properties that can potentially mitigate infection.
Dr Jayadevan also pointed out that unlike masks, eye protection may not be the primary means of safeguarding against Covid-19 transmission.
Meanwhile renowned ophthalmologist Dr Ravindra Mohan, Director of Trinethra Eye Care in Chennai, said that during the pandemic, he had observed a variety of findings related to Covid-19, and pink eye was one of the most common symptoms seen in patients.
However, he clarified that the primary cause of pink eye cases at this time was due to the seasonal virus epidemic, which is prevalent in India, particularly during the rainy season when hygiene is compromised. For instance, this epidemic is a long-standing issue in the region, with historical associations dating back to events like the 1971 Bangladesh war.
He further explained that it is even called “Madras eye” as the association of the adenovirus and conjunctivitis was first described by the Regional Institute of Ophthalmology in Chennai, one of the oldest such institutions in the world.
Dr Mohan pointed out two reasons why it is challenging to directly correlate pink eye cases with Covid-19 or its variants.
“First, routine testing for specific viruses like SARS-CoV-2 is not feasible due to the associated costs and lack of widespread availability. Second, the severe systemic symptoms seen in Covid-19 patients during the peak of the pandemic have largely subsided, making it less likely for pink eye cases to be directly linked to the virus,” he told South First.
He stressed that there is no cause for panic at the moment regarding pink eye cases and that he has not come across any published literature or warnings from reputable institutions indicating a significant correlation between pink eye and Covid-19 or its variants.
In response to concerns about testing for Covid-19 in patients with pink eye and fever, medical professionals emphasise that the majority of viral conjunctivitis cases are caused by the seasonal adenovirus and follow a typical pattern of response. Therefore, routine testing for Covid-19 in all viral conjunctivitis patients is not mandatory.
“Instead, testing for Covid-19 is reserved for those with a high index of suspicion or cases of viral conjunctivitis that do not follow the expected response or display increased contagiousness,” said Dr Suhasini.
The importance of maintaining strict hand hygiene and necessary precautions to prevent the spread of all infectious diseases, including viral conjunctivitis, cannot be overstated.
However, doctors insist that those individuals experiencing symptoms of pink eye or any respiratory illness are encouraged to seek medical attention promptly to receive appropriate care and advice.
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