Case of the Month

Presented by B Ticho:

I was consulted to see this 34-year old who was intubated in the ICU for complications of COVID-19 infection. The ICU team had been using artificial tear ointment on both eyes for over a week, without any improvement in the condition. His respiratory status was tenuous and he was also somewhat fluid overloaded.

Many people have asked me about the ocular complications of COVID-19 infections. Initial reports suggested that COVID conjunctivitis would be a very common presentation — after all, the initial disease warnings were sounded by a Wuhan ophthalmologist (https://en.wikipedia.org/wiki/Li_Wenliang). Fortunately, while red eyes continue to be a COVID feature, this has not proven to be a frequent presenting issue, in my experience.

This gentleman’s ocular condition turned out not to be directly related to his coronavirus infection, but is an occasional complication of comatose status/chronic intubation with fluid overload. I performed a simple surgical procedure at the ICU bedside which eventually corrected his rather dramatic eye findings.

Benjamin H. Ticho, MD