COVID-19 ocular findings in paediatric population

Abstract Purpose To investigate and describe ocular findings in COVID-19 paediatric patients. Methods A total of 17 COVID-19 patients aged between 0 and 17 years old were recruited at the Paediatric Hospital of La Paz University Hospital (Madrid, Spain). A complete ophthalmological examination was performed in all patients. Results Of 17 patients, 50% had a known COVID-19 previous exposure. PCR from nasopharyngeal swabs was positive in 35.29%, whereas IgM and/or IgG serology tests were positive in 81%. Clinical manifestations were: 6 COVID-19associated Paediatric Inflammatory Multisystem Syndrome (PIMS), 7 pneumonias and 2 cutaneous purpura and/or chilblains. Ocular findings were ocular hyperaemia (5 patients), as bilateral acute conjunctivitis (3 patients) or unilateral episcleritis (2 patients). Mean best corrected visual acuity was 1/1 in all tested cases. Only one patient, presenting unilateral optic neuritis, had visual symptoms as unilateral inferior temporal quadrantanopsy. Retinal involvement was found in one patient, where ocular fundus exam showed unilateral retinal vasculitis. Conclusion SARS-CoV-2 infection could produce ocular pathology in children, frequently presented weeks after the acute phase of the disease. We should take into account COVID-19 when performing differential diagnosis of children presenting with conjunctivitis, episcleritis, retinal vasculitis and/or optic neuritis, meanwhile this world-wide pandemic lasts.