Do glasses protect against COVID-19 or make you more vulnerable to the disease? What about wearing contacts? The first few months of the COVID-19 pandemic were confusing for people who wear corrective lenses. First, a national ophthalmological society said that contact wearers should switch to glasses if they could, to avoid spreading infection by touching their eyes. Later, a commentary in a medical journal said that wearing glasses might increase the risk of COVID-19, because wearers touch their faces to adjust their frames during the day.
In September 2020, a study was published based on data from Suizhou Zengdu Hospital in Suizhou, China, about 90 miles from Wuhan, where the virus was first reported. The researchers observed that fewer people hospitalized with COVID-19 wore glasses than might be expected based on the percentage of adults in China who wear glasses. The study found that wearing glasses all day protected people from COVID-19 infections.
That study got media attention, including an article in The New York Times. However, because it was a study that was based on the researchers’ observations rather than an experiment, it was missing some of the pieces that medical doctors look for when deciding whether they let a research finding inform the way they treat their patients, such as a control group.
“It was unconventional,” says Marlene Durand, director of infectious diseases at Mass Eye and Ear in Boston, and professor of ophthalmology at Harvard Medical School. “Of the 276 people in the study, none wore contact lenses or had refractive surgery to correct their vision. That’s quite different from the U.S., where about 45 million people wear contact lenses.” According to the CDC, about 16 percent of U.S. adults over 25 wear contacts.
What is a corrective lens wearer to do?
“While I think that particular study overstated the finding, there is an accumulation of evidence that says eye protection could have a protective effect,” says Elias Duh, a professor of ophthalmology at the Wilmer Eye Institute at Johns Hopkins University. “The effect is not as great as wearing a mask, but it is still helpful.”
SARS-CoV-2 and the Eye
Duh was part of a team of Johns Hopkins researchers who were intrigued by the case of Joseph Fair, a virologist and NBC medical contributor, who believes he contracted COVID-19 through his eyes, which were unprotected on a crowded flight while he wore a mask and gloves. The research team was also drawn in by a June report in the medical journal The Lancet that showed that eye protection helped reduce the risk of COVID-19 infection, although the study found that eye protection was not as effective as distancing or wearing a mask.
The Johns Hopkins team wanted to know if the cells in eye tissue have the proteins that would allow SARS-CoV-2 to enter. They collected tissue samples from patients undergoing eye surgeries and from cadavers to check for these key proteins: ACE2 and TMPRSS2. Both were found on the surface of the eye.
The researchers concluded that eyes are indeed vulnerable to SARS-CoV-2. That means you can get COVID-19 through your eyes, Duh explains, because our eyes are connected to our noses and our throats through our tear ducts. “The transmission can be even more direct, by rubbing the eye and touching the nose,” he says.
But Duh doesn’t think we should all be adding goggles to our COVID-19 prevention kits. Based on the Lancet study, he sees eye protection as a third line of defense, not the first. Goggles or other eye protection might be helpful for health care providers treating COVID-19 patients, he says, or for people caring for COVID-19 patients at home. In these cases, he doesn’t think glasses offer enough protection.
Durand agrees. She points out that wearing goggles or a face shield was a standard precaution among health care providers long before the pandemic. Eye protection is already used when there is a chance that a patient’s secretions (such as tears or saliva) could splash into the eyes, nose or mouth of a health care provider. Glasses aren’t sufficient protection in those situations, she says.
The comparatively low level of protection from glasses is one reason why Duh believes that corrective lens wearers should stick with whatever they normally use, whether it’s glasses or contacts. Glasses might provide protection from someone sneezing in your face, he says, but otherwise, he doesn’t think glasses provide enough of a benefit from the virus for contact lens wearers to switch. This is especially true since contact lens wearers who are not used to glasses might fidget with their glasses more, increasing their odds of transporting the virus from their hands to their face. It’s important for contact lens wearers to wash their hands carefully before inserting or removing their contacts, Duh says, which is something they should be doing anyway.
Contacts and COVID
While contact lenses cover part of the eye, they don’t cover enough of the eye to help prevent a COVID-19 infection, Duh says. The research team found the ACE2 and TMPRSS2 receptors not only in the cornea, but also in the conjunctiva that covers the whites of your eyes and the inside of your eyelids. The tears that bathe our eyes constantly would wash the virus around the eye, where it would quickly reach receptors not covered by the contacts.
The bottom line is that the best protective measures against COVID-19 are social distancing, mask-wearing and hand washing, Duh says. Stick with those and you should be well protected, and whether you wear glasses, contacts or neither shouldn’t make much of a difference to your health.