To the Editor We congratulate Wu et al1 for their article on the ocular manifestations of coronavirus disease 2019 (COVID-19). The authors reported that 12 of 38 patients (31.6%) with COVID-19 had ocular signs and symptoms. They described epiphora, conjunctival congestion, increased secretions, and chemosis that occurred more frequently in patients with severe systemic manifestations. Although it is true that these signs may occur in viral conjunctivitis, they are also very common findings and may occur in other ocular conditions, such as blepharitis, uveitis, keratitis, or systemic conditions, such as fluid overload. How did the authors account for whether these other diagnoses were coincidental to COVID-19? In addition, could the authors explain how the ocular assessment was performed (eg, by an ophthalmologist vs another specialist, such as an internist)? Also, could the authors summarize at what point in the course of the disease the reverse transcriptase–polymerase chain reaction test was performed in each patient, which may affect the percentages of positive vs negative results obtained from the conjunctival swabs?
Corresponding Author: Jean-Marie Parel, PhD, Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Ave, Miami, FL 33136 (email@example.com).
Published Online: December 23, 2020. doi:10.1001/jamaophthalmol.2020.5816
Conflict of Interest Disclosures: Dr Parel reported a patent pending (62/812685). No other disclosures were reported.