Omicron’s rapid spread has prompted at least one Canadian doctor to recommend that eye protection be worn when going into a crowded indoor space.
Mary Fernando, who was a family doctor for 30 years in Ontario and is now a writer, said eye protection such as goggles and face shields would offer extra safety for those who want to be particularly careful in busy indoor settings. Her opinion is bolstered by a couple of articles in The Lancet medical journal.
But other doctors say while infection through the eyes is possible, it’s rare. The Public Health Agency of Canada and the BC Centre for Disease Control both recommend eye protection for health care workers or others who may regularly come into contact with COVID-19 patients. But it isn’t required gear for the general public, they say.
Dr. Fernando said as the pandemic is constantly evolving, taking extra precautions could be helpful to some people.
“The problem we’re finding with Omicron is that it has more infected particles and so you may need fewer particles to infect you. … We are hearing so many people who are being very careful and wearing the best mask, sometimes even N95, who are still getting infected,” she said.
In a Lancet study from 2020, three ophthalmologists stated the transmission of COVID-19 through the eyes has been ignored. “The respiratory tract is probably not the only transmission route for 2019-nCoV, and all ophthalmologists examining suspected cases should wear protective eyewear,” they said.
Similarly, in a Lancet study from 2021, an ophthalmologist and an infectious-disease specialist stated there is strong circumstantial evidence to prove COVID-19 can be transmitted through eyes. They point out while eye protection should be used, it depends on the type, as many protectors can obstruct vision or cause fogging, which reduces communication.
But while some experts agree it is possible to catch COVID-19 through your eyes, other experts say the chances are minimal.
“What we know about COVID is that it is airborne and there’s a chance that it could get into your eyeball. But the chance of that is, is really, really small,” said Sabrina Wong, professor at the Centre for Health Services and Policy Research and the University of British Columbia school of nursing.
“The risk of someone getting that close that they’re going to cough and have high concentrations of it near your eyeball is really low,” she said.
Similarly, Kevin Gregory-Evans, an ophthalmology professor at UBC, said it is possible to catch COVID-19 through the eye, but it is the least common way of catching the disease.
The most common is still respiratory, and public-health officials are more worried about what types of personal protective equipment are being used for masks. Surgical or N95 respirator masks are recommended.
“You would need a lot of virus going into your system in order for you to actually get an infection. So, for it to hit your eyeball where it’s primarily spread through the air, there’s just less surface area than if you think about how much surface area there is in your lungs,” Dr. Wong said.
Leighanne Parkes, an infectious-disease specialist and medical microbiologist at the Jewish General Hospital in Montreal, said transmission of droplets can occur through your eyeball, but wearing PPE for your eyes is based on your risk.
“We know that a lot of our transmission right now is coming from households and it’s really hard to walk around your household at all times with a respirator and a full face shield. Like I wear these at work all day – I don’t particularly want to shower with it and sleep with it on,” she said.
She also pointed out that certain individuals, such as health care workers or aestheticians who get close to other people’s faces, are in settings where they would be exposed for longer and more close-up to droplets, which is why they take the extra precaution of wearing PPE such as goggles and face shields.
“I think the bottom line is it really depends on what your risk is. And if the risk assessment says maybe I should protect my eyeballs, because of the encounters that I’m engaging in, then maybe it’s a good idea to use it. But I think for, you know, quick trips to the grocery store and being at home, it’s probably not going to be the thing that stops any type of transmission,” she said.
Dr. Gregory-Evans also said if someone is concerned about catching COVID-19 because they are in a setting where they are at high risk and close contact, then it could be a good idea, but for the general public it is up to their discretion.
“I think a lot of people are looking for one thing that will guarantee that they will not get COVID. And the answer to that is that there is no absolute way to guarantee by any one single measure that you will not get COVID infection. It’s all about risk, and it’s about acceptable risk,” he said.
Currently, the Public Health Agency of Canada does not have a recommendation on the use of eye protection for the general public in public indoor or outdoor spaces during regular activities.
Public Health said some people may choose to wear face shields, but this should be in addition to wearing a mask or respirator, not as a replacement for one.