What ophthalmologists should know about conjunctivitis in th
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As ophthalmologists, you have been in the news right from the early days of COVID‑19 pandemic. Ophthalmologists have been infected and have unfortunately even succumbed to COVID‑19. A report of one of them being possibly infected through the ocular mucosa and then developing systemic symptoms gave rise to widespread panic, opening up the possibility of COVID‑19 manifesting initially as conjunctivitis and the further likelihood of disease transmission through ocular secretions of infected patients.

A combination of an antibiotic and a lubricant, e.g., Ciprofloxacin hydrochloride 0.3% or Moxifloxacin hydrochloride 0.5%, 4‑6 times a day for two weeks and carboxymethyl cellulose 0.5% or sodium hyaluronate 0.1%, 4‑6 times a day for 2 weeks, can be a standard pre‑prepared package so that it can be dispensed immediately to the patient. This obviates the need for the patient to go to the common pharmacy area. For analgesia, non‑steroidal anti‑inflammatory drugs (NSAIDs) such as Ibuprofen is better avoided as they have been shown to worsen the systemic effects of COVID infection and oral Paracetamol can be added instead. It is best to avoid topical steroids during the pandemic as far as possible, as we may not be in a position to bring patients back for frequent follow‑ups to monitor intraocular pressure.

Hydroxychloroquine (HCQ) has been shown to be effective in decreasing the viral load in systemic COVID‑19 infection and its effects are enhanced in association with Azithromycin.[24] HCQ, the drug used in malaria, is proposed to work in this condition, by inhibiting viral attachment and RNA fusion inside the host cells. With relevance to ophthalmology, Chloroquine eye drops (0.03%) is available and has been studied in dry eye disease in a twice-daily dosage with no reported adverse events over a 28‑day period of use.By an extension of its systemic effect, this could probably be used as a potential agent in the treatment of conjunctivitis caused by enveloped viruses including COVID‑19.