The pandemic has not only severely affected the respiratory tract, but also the eyes and visual system of many people.

Microthrombi in the retina of COVID-19 patients

One of the first notable observations was the discovery of microthrombi in the retina of COVID-19 patients. Ophthalmologists realised that these small blood clots impair blood flow to the eye, which can have serious consequences for vision.

The main factors by which COVID-19 (corona) can affect eye health include:

Factor 1: Endothelial dysfunction

The endothelial cells that line the blood vessels can become inflamed and lose their ability to regulate blood flow and prevent the formation of blood clots. This leads to circulatory disorders of the retina and the optic nerve.

Factor 2: Inflammatory reactions

COVID-19 triggers what is known as a cytokine storm. An excessive production of pro-inflammatory cytokines. This promotes the formation of blood clots and can lead to retinal occlusions or eye infarctions.

Factor 3: Immune thrombosis

The close connection between the immune system and blood clotting can be disrupted by COVID-19, leading to increased clot formation. These clots can block the blood supply to the retina and optic nerve.

Factor 4: Blood vessel damage

The inflammation caused by the infection can affect the flexibility of the blood vessels and promote their hardening. This hardening creates conditions that favour the formation of blood clots.

Eye damage due to corona (COVID-19)

In our practice, we are receiving an increasing number of questions about the connection between coronavirus disease, the coronavirus vaccination and worsening eye conditions, such as sudden eye inflammation that is difficult to treat or eye thromboses that occur immediately after the vaccination.

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We have also observed cases of wet macular degeneration following infection, even in younger people. These findings show that the Sars-CoV-2 coronavirus can affect not only the respiratory tract, but also other organ systems such as the nervous system.

Increasing evidence: coronaviruses also penetrate the retina of the eye

There is increasing evidence that coronaviruses can also penetrate the retina of the eye and cause damage there. A team of researchers has shown that Sars-CoV-2 can infect retinal cells and multiply there. These findings emphasise the need to monitor retinal damage as a possible consequence of long Covid.

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Effects of treatment with COVID-19 on the eye

The use of steroids in the treatment of COVID-19 patients has in some cases led to an increase in intraocular pressure and thus to an increased risk of glaucoma. This adverse side effect shows how complex the treatment of COVID-19 can be and how important it is to consider all possible consequences.

Measures to improve eye health

The importance of regulating the immune system and reducing inflammation and oxidative stress cannot be overemphasised.

Some of the recommended measures are:

  • Acupuncture: very effective in regulating the immune system and reducing inflammation.
  • Food supplements: Glutathione, omega-3 fatty acids and vitamin D3 are particularly helpful.
  • Healthy diet: A balanced diet high in antioxidants can help reduce oxidative stress.
  • Hydration and exercise: Adequate hydration and regular exercise promote overall health and well-being.

In addition, omega-3 fatty acids for elastic blood vessel walls, a good vitamin D3 level, an alkaline diet and the intake of anti-inflammatory substances such as turmeric and boswellia are recommended.

OPC can help to make the blood less susceptible to clotting. The gut also has a special influence on the immune system and should always be taken into account in post-Covid-19 diseases.

Nerve damage due to COVID-19

Reduced nerve density in the cornea

A cross-sectional study in the British Journal of Ophthalmology showed that patients who were slow to recover from their symptoms after overcoming COVID-19 showed a reduced density of nerve fibres in the cornea, while the number of dendritic cells there appeared to be increased.

Indication of neurological causes

This could be an indication of a neurological cause of the secondary disease. The cornea of the eye is one of the areas with the highest nerve cell density outside the brain and plays a decisive role in the eyelid closure reflex.

Results of previous studies point to changes in nerve cells in diabetic neuropathy

A team led by Rayaz Malik from the University of Manchester has already described changes in nerve cells in diabetic neuropathy in previous studies and observed an increase in dendritic cells, which are antigen-presenting cells responsible for detecting pathogens.

Current study on post-COVID patients

In a recent study, the team examined the corneas of 40 COVID-19 patients and found that the density of nerve fibres and the length of nerve fibres in the cornea were reduced in post-COVID patients. The differences were significant when healthy individuals were compared to post-COVID patients suffering from neurological disorders.

Increased number of dendritic cells

In dendritic cells (highly specialised antigen-presenting cells that initiate and regulate antigen-specific immune responses), both the number of “mature” cells (with the protrusions typical of these cells) and the number of “immature” cells was increased.

This indicates an increased activation of the immune system. If these results are confirmed in further examinations, an ophthalmological examination could support the diagnosis of post-COVID syndrome.

This comprehensive information will help to better understand the potential impact of COVID-19 on eye health and to take appropriate measures to support eye health.

Summary

The pandemic not only affected the respiratory tract, but also the eyes and the visual system.

Microthrombi in the retina
COVID-19 patients had microthrombi in the retina, which can affect blood flow and vision.

Main factors affecting the eye:

  • Endothelial dysfunction: Inflamed endothelial cells lead to circulatory disorders.
  • Inflammatory reactions: Cytokine storms favour the formation of blood clots.
  • Immune thrombosis: Impaired interaction between the immune system and blood clotting promotes clot formation.
  • Vascular damage: Inflammation promotes vascular hardening.

Eye damage due to corona
Questions about eye inflammation and eye thrombosis after corona diseases or vaccinations are becoming more frequent. Coronaviruses can infect and damage the retina.

Effects of treatment
Steroid treatments for COVID-19 can increase intraocular pressure and increase the risk of glaucoma.

Measures for eye health
Acupuncture, dietary supplements (glutathione, omega-3, vitamin D3), healthy diet, hydration and exercise are recommended.

Nerve damage
Studies show a reduced nerve density in the cornea and an increased number of dendritic cells in post-COVID patients, which indicates increased immune activation.

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