Juan Ding, OD, PhD

Just the first week in 2024 back in clinic, I started seeing several pink eye cases. Some of these have one thing in common, that the patient recently had covid or other viral illnesses.

Patient #1 had covid related pneumonia and recovered 4 weeks later, her red eyes onset just a few days after pneumonia diagnosis. With treatment of doxycycline respiratory symptoms almost resolved, but red and painful eyes persisted. There was even involvement of the cornea and the iris (keratitis and uveitis).

Patient #2 had covid with bad symptoms (upper respiratory, fever and fatigue), but no pneumonia. Red eyes onset after she almost recovered fully from covid. The conjunctivitis appeared viral, no involvement elsewhere in the eye.

Patient #3 had cold symptoms, but did not test positive for covid, and we don’t know what virus he had. After he almost recovered from the coughing symptoms, his eyes became red. Only conjunctivitis and no cornea involvement.

There were earlier reports in 2020 when covid first came out that pink eye, or conjunctivitis, could be the first symptom and sometimes the only symptom of covid. I have not read much that the eye symptoms come after acute covid symptom resolution. But apparently that could happen, as I saw a cluster of these just in 2 days. It is common to see viral conjunctivitis showing up at the same time or some days after the cold symptoms such as in patient #1, not too often when the cold symptoms completely resolve like in patients #2 and 3. Of course, patients could be having different interpretations about the resolution of the respiratory symptoms- it’s possible they are just getting much better and not completely over the cold.

Anyway, in the peak of all the viral infections in January and February, you may come down with red eyes when you have a cold, sometimes even after coming out of a cold. Sometimes it’s not just a pink eye, it can be infection or inflammation of the deeper structure of the eye, and it is best go see an eye doctor.

Leave a comment below, when you had a pink eye, was it stand alone, or before or after cold symptoms?