Reply to ocular manifestation, eye protection, and COVID-19

Dear Editor,

We would like to thank Dr. Mungmungpuntipantip for his comments to our article [1].

We would like to reiterate the importance of eye protection for ophthalmologists. As stated in our article, ophthalmologists are in close proximity with patients during both slit lamp examination and direct ophthalmoscopy [2]. Protective eyewear can prevent direct inoculation of respiratory droplets through the conjunctiva. Secondly, protective eyewear can act as a barrier to prevent ophthalmologists from inoculating the virus directly into their own conjunctiva, through inadvertent eye rubbing with a contaminated hand. Thirdly, conjunctivitis, though rare, could be the first presentation of COVID-19 [3], and the SARS-CoV-2 virus has been isolated in tears of COVID-19 patients [4]. Ophthalmologists may be caught off-guard if these conjunctivitis patients without any respiratory symptoms present to the eye clinic. Proper protection with face masks and eyewear would help to lower the risk of transmission.