Unilateral conjunctivitis as first presentation of Coronavirus Disease 2019 (COVID-19): A telemedicine diagnosis.

A 27-year-old man consulted his ophthalmologist by telemedicine in Argentina during Coronavirus Disease 2019 (COVID-19) pandemic, because of foreign body sensation and red left eye. The patient did not present epiphora, secretion or decreased vision. There was no systemic symptoms. Personal history was unremarkable and he was a non-smoker sportsman. External examination revealed unilateral eyelid edema and moderate conjunctival hyperemia (Fig. 1 ). A topical association of antibiotic and corticoids was prescribed. Three hours later, the patient presented severe headache and fever at 39 °C and he developed 12 hours later, cough and severe dyspnea impairing speech. RT-PCR from nasopharyngeal swabs resulted positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eleven days later, a second consultation by telemedicine showed that ocular signs had resolved. Dyspnea and cough were less severe but still present. This case illustrates the interest of telemedicine in Ophthalmology during the COVID-19 pandemic, since a moderate conjunctivitis could be the first sign of a severe respiratory distress.

Figure 1

Smartphone photograph of a left eye conjunctivitis as first presentation of Coronavirus Disease 2019 during teleophthalmology consultation. A. Left eyelid edema. B. Moderate temporal conjunctival hyperemia of the left eye. C. Inferior bulbar conjunctival hyperemia of the left eye.

Disclosure of interest

The authors declare that they have no competing interest.