Ophthalmology AdvisorEye Pain Following COVID-19 Can Last For Years, Even Without Clinical Signs

⚠️ Small Study / Early Comparative Evidence

Researchers evaluated 26 patients previously hospitalized with COVID-19, including participants with and without ocular symptoms during acute infection. At a median 2.77-year follow-up, persistent or newly developed symptoms occurred despite broadly similar tear-film, ocular-surface, and corneal findings between groups.

Clinical Considerations

• 12 of 13 patients with acute ocular symptoms remained symptomatic, while 4 initially asymptomatic patients developed symptoms by follow-up.
• Symptomatic patients had higher Ocular Surface Disease Index scores, averaging 41.5 versus 21.8 in the comparison group.
• 43.8% of symptomatic participants did not improve with topical oxybuprocaine, supporting further investigation of mechanisms beyond the ocular surface.
• Tear function, staining measures, gland dropout, corneal sensitivity, and other conventional findings were generally similar between groups.
• The small cohort, selection and attrition biases, and potential environmental or systemic confounders substantially limit generalizability.

Practice Applications

• Recognize persistent ocular discomfort can occur despite limited findings on conventional ocular-surface evaluation.
• Consider mechanisms beyond measurable surface disease when symptoms and clinical signs are discordant.
• Interpret anesthetic nonresponse cautiously because this small study does not establish a neuropathic mechanism.
• Monitor future studies clarifying post-COVID ocular symptoms and potential neuroinflammatory or neuropathic contributions.