By any standard, our national hero, Jose Rizal, is one of the most interesting, brilliant, enigmatic, charismatic, and controversial figures in history. There seems to be always something new to discover about him and debates around him prevail to this day. It is no wonder, therefore, that this year 2011, the 150th anniversary of his birth, almost every columnist, every commentator, every radio and television station, has had something to say about some special “little known” facts about our national hero. During the past year, there had been numerous reports in all forms of media about Rizal as sportsman and excellent student, as someone who had prophetic dreams, as a world traveler, a romantic, an artist, a political activist, as polyglot who spoke 22 languages and dialects, and of course, as a writer and martyr. Even topics as mundane as where he tied his horse when he visited his childhood sweetheart have generated interest. The list goes on and on.
Ophthalmologists

Professor Salvador Salceda described the history of Philippine eye banking as “a fascinating if not frustrating one”. This is evident in his Geminiano de Ocampo Medical Research Foundation Centennial Lecture where he traced the ebb and flow of Philippine eye banking from 1948 until the birth of the Eye Bank Foundation of the Philippines in 1994 and the start of operations of its Medical Eye Bank in 1995.1 The story of Philippine eye banking remains a fascinating one, but it has fortunately also been blessed with many moments of success and satisfaction even while still laden with frustration. In an editorial about the Eye Bank in 2005, I wrote that “while the achievements after ten years of operations can be considered a success story, we have really only started to plant the seeds”.2 And now, thirty years hence, after the COVID-19 pandemic that saw the number of cornea retrieval procedures plunge throughout the world, I believe we are starting to reap the harvest from the seeds planted throughout the last three decades.
Eye Banks

BACKGROUND AND OBJECTIVES

The global pandemic caused by Coronavirus Disease 2019 (COVID-19) has affected millions, with growing evidence of the potential role of ocular tissues in viral transmission. At the time of writing, local data regarding the phenomenon was limited. This study investigated external ocular manifestations in patients with COVID-19 at a referral center in the Philippines, examined correlations between demographics, systemic manifestations, and laboratory results with ocular manifestations, and determined their timing relative to systemic symptoms.

METHODS

This single-center, descriptive cross-sectional study was carried out from December 8 to 18, 2020 at the adult COVID-19 wards of the Philippine General Hospital involving 72 participants. Data collection involved relevant clinical history taking and performing gross eye examination. The prevalence of ocular manifestations was described with 95% confidence intervals. Correlations between ocular manifestations and quantitative variables were analyzed with point-biserial correlation, and associations with qualitative variables were tested using chi-square or Fisher’s exact tests.

RESULTS

Among participants, 31.9% presented with ocular manifestations with foreign body sensation as the most prevalent ocular symptom (11.1%) and conjunctival hyperemia as the most prevalent ocular finding (19.4%). The median age of patients with ocular manifestations was 41 years old with a higher prevalence in the male population (73.9%, CI=95%, p=0.001). No significant correlation was observed between presence of external ocular manifestations and the different systemic and ocular co-morbidities as well as with COVID-19 clinical classification. Among those who experienced symptoms, majority (29.2%) of the patients experienced systemic symptoms prior to the onset of ocular symptoms. Ocular complaints may present as the sole manifestation (13.9%). Several laboratory parameters were measured and only temperature and AST levels showed a low positive correlation with the presence of ocular manifestations. 

CONCLUSION

Ocular manifestations occur in roughly one third of patients with COVID-19 based on this study population. With some individuals presenting with ocular signs or symptoms as the initial and sole manifestation, healthcare practitioners must exercise caution and remain vigilant in managing patients who present as such. At the time of writing, this is the first local study investigating the different external ocular manifestations in patients with COVID-19. There is a need to pursue more robust studies and conduct more local investigations which will guide both ophthalmologists and other practitioners in strengthening existing guidelines regarding precautionary practices, clinical diagnosis, and management of COVID-19 patients.

Human ; Sars-cov-2 ; Covid-19 ; Philippines