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IN-DEPTH: Study suggests eyeglasses may reduce risk of COVID infection. Should we all wear eye protection?

CDC urges healthcare workers to protect eyes
Study suggests eyeglasses may reduce risk of COVID-19 infection
Posted at 5:58 PM, Sep 24, 2020
and last updated 2020-09-25 13:17:54-04

SAN DIEGO (KGTV) -- We know the importance of wearing a mask to protect the nose and mouth from the novel coronavirus, but some new research is raising questions about whether the general public should wear goggles, glasses or a shield to protect their eyes.

The CDC already urges healthcare workers to wear eye protection. The agency updated its guidance in July, encouraging even healthcare workers in low-transmission environments to wear eye protection when it was previously listed as “optional.”

Experts think the nose is still the main entry point for the virus because of the mechanics of breathing, but the surface of the eye is lined with the same mucous membrane to which the virus likes to bind.

Animal studies have shown SARS-CoV-2, the virus that causes COVID-19, can enter through the eyes and there have been viral particles detected in human tears, but there’s no clear-cut data so far showing the eyes are a major entry point, said ophthalmologist Dr. Annie Nguyen at the USC Roski Eye Institute.

However, some observational studies have suggested protecting the eyes may lower the risk of infection.

In June, a study in the Journal Lancet suggested face shields, goggles and glasses could lower the risk of infection from 16 percent to 6 percent.

Another study published this month suggests that simply wearing eyeglasses could help.

Researchers examined 276 hospitalized patients in Suizhou, China. Based on trends in that region, they expected about 31 percent of the patients would wear eyeglasses. Instead, just 5 percent of the hospitalized patients wore glasses.

The researchers noted the observational study had limitations, but theorized that eyeglasses may offer a protective barrier against the virus.

“I wouldn’t be quick to make the recommendation for everyone to run out and wear glasses,” Dr. Nguyen said.

An editorial published alongside the eyeglasses study urged caution. “Although it is tempting to conclude from this study that everyone should wear eyeglasses, goggles, or a face shield in public to protect their eyes and themselves from COVID-19, from an epidemiological perspective, we must be careful to avoid inferring a causal relationship from a single observational study,” wrote Dr. Lisa Maragakis at Johns Hopkins University School of Medicine.

Experts say more evidence is needed because urging people to wear eye protection could have harmful side effects, like causing the wearer to inadvertently touch their face more frequently.

“If there is additional evidence that builds up, then that’s the point that we change guidelines,” said Dr. Christian Ramers of Family Health Centers of San Diego.

“People have had whiplash from things changing and going back and forth,” he added, citing the change in guidelines on face coverings.

Still, some experts say people with underlying conditions should consider adding eye protection, as long as they’re careful not to touch their face.

Doctors have suggested that people who wear contact lenses might want to switch to eyeglasses to cut down on the number of times they touch their eyes, but Dr. Nguyen said there’s no hard data yet showing contact lens-wearers are at greater risk from the virus.