Itchy Eyes and Conjunctivitis Might Be the Latest COVID-19 Symptoms

Experts are seeing a new symptom emerge from the latest COVID-19 subvariant: conjunctivitis, also known as “pink eye.”

As the symptoms of COVID-19 changed over time with each new emerging variant, common complaints became suspicious. Just as a runny nose can no longer be immediately dismissed as “just a cold” or allergies, now red and itchy eyes, especially in babies and young children, may not be caused by cold viruses — instead, it could be a symptom of XBB.1.16, an omicron subvariant now being closely monitored across the world.

XBB.1.16 More Likely to Cause Fever and Pink Eye

The new subvariant, dubbed “arcturus,” has been reported in 29 countries, according to the World Health Organization (WHO). Although the earlier subvariant XBB.1.5 is still responsible for the majority of COVID-19 cases in the United States, per the Centers for Disease Control and Prevention (CDC), XBB.1.16 infections are rising quickly, with the percentage of cases nearly doubling from 3.9 to 7.2 percent in the last week.

Although the new variant is very similar to XBB.1.5, it has one additional mutation in the spike protein which makes it more contagious, says William Schaffner, MD, professor of preventive medicine and infectious diseases at Vanderbilt University in Nashville, Tennessee.

Arcturus also has two somewhat distinctive clinical features, says Dr. Schaffner. “It is more likely than the other omicron variants to produce fever and it is producing conjunctivitis (pink eye), especially in children. So far, the pink eye appears to last several days to a week, similar to the conventional viral pink eye,” he says.

It’s Doubtful That Pink Eye Will Be a Major Way That COVID-19 Spreads

Schaffner doubts that pink eye presents a major new way of spreading the virus. “But because the virus can get on the fingertips and is so contagious, there likely is some more person-to-person spread, particularly among children,” he says.

Doctors in India First Spotted Pink Eye in Young Children and Babies with COVID-19

Arcturus was first discovered in January and is spreading notably in India, says Schaffner. Healthcare providers there began to see conjunctivitis as a COVID-19 symptom in early April.

“For the last 2 days, have started getting pediatric COVID cases once again after a gap of 6 [months]! An infantile phenotype seems emerging — treated infants w/ high fever, cold & cough, & non-purulent, itchy conjunctivitis w/ sticky eyes, not seen in earlier waves,” read an April 6 tweet by Vipin Vashishtha, MD, a pediatrician at Mangla Hospital in Bijnor, India, and former head of the Indian Academy of Pediatrics Committee on Immunization.

Other Respiratory Viruses Have Eye Symptoms

This new symptom of COVID-19 isn’t surprising, “because many respiratory viruses include eye symptoms in their spectrum of illness,” says Amesh Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore.

In fact, most cases of pink eye are caused by adenovirus, but also can be caused by other viruses, including herpes simplex virus and varicella-zoster virus, according to Johns Hopkins Medicine.

Adenoviruses are a group of viruses that typically cause respiratory illnesses, such as the common cold, conjunctivitis, croup, bronchitis, and pneumonia, according to the Children’s Hospital of Philadelphia (CHOP).

Treatment and Prevention of COVID-19 and Pink Eye

The treatment for COVID-related conjunctivitis is symptomatic, says Schaffner. That means prescribed eye drops or ointment will improve eye symptoms without addressing the basic cause of the disease.

To prevent the spread of XBB.1.16, all the usual COVID-19 precautions should be taken, and it’s also important to avoid people with pink eye and to emphasize frequent handwashing, says Schaffner.

COVID-19 testing still detects this variant quite well, and so people who think they may have been infected should be tested, says Paul Pottinger, MD, professor in the division of allergy and infectious diseases at the University of Washington School of Medicine in Seattle.

For adults and children who are not yet fully vaccinated and boosted, the new subvariant is “another good reason to get that taken care of,” says Dr. Pottinger.