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Subspecialties Health Economics and Policy, Comprehensive, COVID-19

The Complexities of COVID-19 in Ophthalmology

With Michelle YT Yip, Ji Peng Olivia Li, Jessica Shantha, Steven Yeh, James Chodosh, Adrian T Fung, Haotian Lin, Jod Mehta

We are currently living in the COVID-19 pandemic; a formal declaration by the World Health Organization (WHO) on March 11, 2020, and a public health emergency of international concern. Although the origin of this outbreak is still speculative, authorities in the WHO Country Office in China were first alerted to a “pneumonia of unknown etiology” on December 31, 2019, when a cluster of cases were detected in Wuhan, Hubei, China.

The virus isolated from these patients has not been previously isolated from humans, suggesting a novel pathogen. Since then, it has spread to over 150 countries and territories in the last few months. The rapid expansion and severity of the virus has alarmed citizens, heads of state, and WHO leaders across the globe. We explore the COVID-19 outbreak in relation to the role of the eye, risks to ophthalmologists, and measures to reduce transmission.

Global prevalence and virology

As of April 16, there have been more than 2 million cases worldwide, claiming almost 150,000 lives (1). 

COVID-19 is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), belonging to the Coronaviridae family. This family is characterized as an enveloped, positive-sense, single-stranded ribonucleic acid (RNA) virus which, when visualized on electron microscopy, have unique characteristic surface projections resembling a corona, “crown” in Latin. SARS-CoV-2 is similar to the severe acute respiratory syndrome coronavirus (SARS-CoV) that plagued the East in 2003. Based on phylogeny, taxonomy and established practice, it has been determined to be the same species. Other viruses in this family include the Middle East respiratory syndrome coronavirus (MERS-CoV), the causative virus for the MERS outbreak that started in 2012 and was first isolated in Saudi Arabia. The COVID-19 pandemic is the third cross-species spillover of animal coronavirus to humans in the last two decades to result in outbreaks. Although these three coronaviruses have been at the center of attention in recent years, there are other human coronaviruses responsible for causing mild upper respiratory symptoms commonly reported as a cold.

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About the Author

Daniel Ting

Vitreoretinal Specialist at the Singapore National Eye Center, Assistant Professor of Ophthalmology at Duke-NUS Medical School, Singapore, and Adjunct Professor at the State Key Laboratory of Ophthalmology at Zhongshan Ophthalmic Center in China.

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