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Published on: May 25, 2022
Ocular manifestations of COVID-19 in the pediatric age group
Muhannad A Alnahdi1,2,3, Maan Alkharashi4,5,6
1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
Insights
COVID-19 can cause various eye problems in children, including conjunctivitis and optic neuritis. These pediatric ocular manifestations, often linked to multisystem inflammatory syndrome in children (MIS-C), generally have positive outcomes with good visual recovery.
Area of Science:
- Ophthalmology
- Pediatrics
- Infectious Diseases
Background:
- COVID-19 is linked to diverse ocular issues, with adult manifestations extensively studied.
- Pediatric ocular manifestations of COVID-19 and MIS-C require further elucidation.
Purpose of the Study:
- To comprehensively review and outline pediatric ocular manifestations associated with COVID-19.
- To differentiate between isolated COVID-19 ocular events and those occurring in MIS-C.
Main Methods:
- Literature review of reported pediatric ocular manifestations.
- Categorization of findings based on COVID-19 association and MIS-C.
Main Results:
- Ocular manifestations occurred across all pediatric age groups (neonates to adolescents).
- Reported conditions include conjunctivitis, episcleritis, optic neuritis, cranial nerve palsies, retinal vascular events, and orbital inflammation.
- Conjunctivitis was most frequent in MIS-C (nearly 50%), with other MIS-C ocular findings including uveitis, corneal issues, and retinitis.
Conclusions:
- Pediatric ocular manifestations of COVID-19 and MIS-C are varied.
- Most children experience favorable visual outcomes with minimal long-term deficits.
- Further research is needed to ascertain long-term visual prognosis.
Abstract:
The coronavirus disease 2019 (COVID-19) is now known to be associated with several ocular manifestations. The literature thoroughly discussed those that affect adults, with a lesser focus in the pediatric age group. We aim to outline the various pediatric ocular manifestations described in the literature. The manifestations may be divided into isolated events attributed to COVID-19 or occurring in the new multisystem inflammatory syndrome in children (MIS-C), a novel entity associated by COVID-19 infection. Ocular manifestations have virtually affected all ages. They manifested in neonates, infants, children, and adolescents. Episcleritis, conjunctivitis, optic neuritis, cranial nerve palsies, retinal vein occlusion, retinal vasculitis, retinal changes, orbital myositis, orbital cellulitis were reported in the literature with this emerging viral illness. Conjunctivitis was the most common ocular manifestation in MIS-C in nearly half of the patients. Other ocular manifestations in MIS-C were anterior uveitis, corneal epitheliopathy, optic neuritis, idiopathic intracranial hypertension, and retinitis. The clinical outcome was favorable, and children regain their visual ability with minimal or no deficits in most of the cases. Further follow-up may be warranted to better understand the long-term effects and visual prognosis.
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