Ebola virus. Image courtesy of American Academy of Ophthalmology
The American Academy of Ophthalmology today issued a statement following a report in the New England Journal of Medicine about an Ebola patient with uveitis, a type of eye inflammation common in Ebola survivors. The academy is reiterating that the findings do not indicate an increased risk of Ebola infection to the general public through casual contact.
According to the study, "Persistence of Ebola Virus in Ocular Fluid during Convalescence," an Ebola patient was discharged after being found clear of the virus by urine and blood tests. Three months later, he returned and was diagnosed with uveitis, which can lead to blindness. Researchers also found evidence of the Ebola virus when testing fluid from inside the globe of the eye but not when testing the tears or the conjunctiva, the surface of the eye and eyelids.
"The medical community has appreciated that the Ebola virus can remain viable in some body fluids for an extended period of time after the initial onset of the disease," says Russell N. Van Gelder, MD, PhD, president of the American Academy of Ophthalmology and a uveitis specialist. "This remarkable case now demonstrates that the virus can remain viable in ocular fluids long after the patient has recovered from the systemic infection. If the Ebola epidemic continues, ophthalmologists throughout the world will be seeing patients with post-Ebola uveitis, will need to recognize and treat this condition and will need to take appropriate increased precautions in performing surgical procedures on these patients. However, I want to emphasize that as far as we know, the Ebola virus is not transmitted by casual contact. The current study does not suggest that infection can be transmitted through contact with tears or the ocular surface of patients who have recovered from their initial infection."
As noted in guidance from the Centers for Disease Control and Prevention (CDC), it is recommended that all health professionals take special precautions when treating patients who are or have been infected with Ebola. These measures include wearing appropriate protective garments, proper disinfection of equipment and employing appropriate waste management to minimize the spread of infection.
The newest findings that indicate uveitis may be associated with active virus within the eye highlight the vital importance of such safety measures for ophthalmic health care professionals when performing invasive procedures such as intraocular injections or surgery for cataracts or glaucoma on patients who have been infected with the Ebola virus.
Studies of prior outbreaks have shown that Ebola infections often manifest in the eyes and can impact vision and cause blindness long after a systemic infection has cleared. One of the early signs of Ebola is conjunctival injection, as observed in a study of the 1995 Ebola outbreak in the Congo.(1) Another study on survivors of the same outbreak found 4 out of 20 Ebola survivors later developed severe uveitis marked by eye pain, light sensitivity, reduced vision and excessive tearing.(2)
Source: American Academy of Ophthalmology