Haemorrhagic conjunctivitis with pseudomembranous related to
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A 63-year-old male was admitted in intensive care unit (ICU), seven days after the beginning of influenza-like symptoms, to manage an acute respiratory syndrome-related with SARS-CoV-2. The chest scan showed interstitial pneumonia with “crazy paving” patterns. At day 19, ocular examination at the patient's bed described petechiae and tarsal hemorrhages, mucous filaments, and tarsal pseudomembranous.

The examination of the posterior segment (fundus examination) was completed at patient's bed with the Schepens ophthalmoscope, and did not identify any vitreous inflammation or retinal abnormalities. At day 20, repetition of conjunctival scrapings and swabs did not identify SARS-CoV-2 by PCR in conjunctival secretions and tears. Azithromycin eyedrop was introduced twice a day for 3 days, with low doses of dexamethasone and daily debridement of pseudomembranous to avoid conjunctival fibrosis and retraction. From day 21 to day 26, the ocular symptoms and conjunctivitis decreased, without corneal complications

In this case, the ocular examination had to be performed at patient's bed because of assisted ventilation and respiratory depression. The first ocular symptoms were developed two weeks after influenza-like symptoms. ICU physicians should be aware of ocular complications in severe COVID-19 patients to prevent sequelae.

Considering that SARS-CoV-2 is present in tears and conjunctival secretions, external ocular infections could be factors of infectious spreading. Physicians should be aware of late (more than 2 weeks) ocular complications in COVID-19 patients to prevent sequelae.

Source: https://www.sciencedirect.com/science/article/pii/S2451993620300876

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