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WATERLOO, Ontario—An extensive literature review, “The ocular surface, coronaviruses and COVID-19,” has been published in the journal Clinical and Experimental Optometry. The review considers a number of questions regarding SARS-CoV-2 transmission and the ocular surface. In a complex and fast-moving subject area, the paper provides “a timely and useful overview of the current evidence base, along with its relevance for clinical practice,” according to an announcement about the review’s publication. In the review, the authors suggest it is possible coronaviruses may not bind to ocular surface cells and initiate infection.

Additionally, hypotheses that the virus could travel from the nasopharynx or through the conjunctival capillaries to the ocular surface during infection are examined.

The authors note in their introduction, “Coronavirus infection is rarely associated with conjunctivitis, with occasional cases reported in patients with confirmed COVID-19, along with isolated cases of conjunctivitis as a presenting sign. Coronaviruses have been rarely isolated from tears or conjunctival swabs. The evidence suggests coronaviruses are unlikely to bind to ocular surface cells to initiate infection. Additionally, hypotheses that the virus could travel from the nasopharynx or through the conjunctival capillaries to the ocular surface during infection are probably incorrect.”

Published May 13, the paper is available at no charge to researchers, ECPs and other health care professionals via open access at https://onlinelibrary.wiley.com/doi/full/10.1111/cxo.13088.

The review is written by Mark Willcox, DSc, director of research at the School of Optometry and Vision Science at UNSW (Sydney), Karen Walsh, MCOptom, professional education team leader and clinical scientist at the Centre for Ocular Research & Education (CORE) at the University of Waterloo, Jason Nichols, OD, associate vice president for research and professor at the University of Alabama at Birmingham School of Optometry, Philip Morgan, PhD, director of Eurolens Research at the University of Manchester, and Lyndon Jones, DSc, director of CORE.

It follows publication of the five authors’ widely read paper in Contact Lens & Anterior Eye, “The COVID-19 pandemic: Important considerations for contact lens practitioners.”