Beyond that, other signs “include the standard common cold-like symptoms” that have been associated with COVID, Dr. Adalja adds.
Wait, why does COVID cause pink eye in some people?
It’s not uncommon for any virus—SARS-CoV-2, the coronavirus that causes COVID-19, included—to cause conjunctivitis, Dr. Schaffner says. In fact, conjunctivitis has been the only COVID symptom in a small number of people, research shows. This is especially true for children, according to the American Academy of Ophthalmology.
It’s also worth pointing out that this potential symptom isn’t entirely surprising, even with the steady rise of Arcturus—experts were exploring pink eye as a possible sign of the virus back in 2020, shortly after COVID-19 was first declared a pandemic.
SARS-CoV-2 can be transmitted via respiratory aerosols or droplets, optometrist Aaron Zimmerman, OD, a clinical professor at The Ohio State University College of Optometry, tells SELF. “These aerosols and droplets can infect someone via the respiratory tract and in the mucus membranes of the eyes,” he explains. “If the surface of the eye is exposed to a high enough concentration of virus, then an infection can occur.” This can lead to what’s known as viral conjunctivitis, aka pink eye, he says. (The conjunctiva is the thin membrane that covers the front of the eye and lines the inside of the eyelids.)
Here’s the thing: There are plenty of other reasons you may develop pink eye. “The conjunctiva can also become infected from bacteria or can be involved in allergic responses,” Dr. Zimmerman says. Further complicating things, he points out that allergic conjunctivitis, which is inflammation of the eyes caused by—you guessed it—allergens like pollen is “quite common in the spring and fall,” and results in red, itchy, and watery eyes. (Bacterial conjunctivitis is also a thing.)
“There are other viruses that cause pink eye but, if you suddenly get pink eye, I would at least consider COVID,” Dr. Schaffner says.
What to do if you’re suddenly dealing with red, irritated eyes
“COVID-related pink eye tends to occur along with other symptoms in the body, such as fever and cough,” Simon Fung, MD, an assistant professor of pediatric ophthalmology at UCLA Health, tells SELF. “Eye allergy is especially common during spring and summertime, so it could all be quite confusing.” That said, there are some key clues that you’re dealing with COVID versus allergies.
If you have what looks like pink eye and develop stringy mucus, or your eyes are really itchy, it’s more likely that you’re dealing with allergies, Dr. Zimmerman says. “One of the biggest differentiators is the symptom of itch, which nearly always accompanies allergic conjunctivitis,” he says.
“If you develop red eyes that are watery, and associated with some mucus but lack itch, then it likely is viral conjunctivitis,” Dr. Zimmerman says. This doesn’t automatically mean you have COVID-19—another common virus like adenovirus, which can cause a cold, could also be the culprit, he adds.
Plus, these aren’t hard-and-fast guidelines: Some people with viral pink eye may experience some itchiness, too. No matter what you think the issue might be, sudden eye symptoms warrant a visit with a doctor, if you have access to one. If a health care provider confirms you are, in fact, dealing with viral pink eye, Dr. Fung says it’s important to try to avoid touching your eyes, or you risk spreading the infection to others. “Artificial tear drops and cold compresses could soothe the symptoms,” he says. “Ideally, you should replace the eye makeup you used before getting the pink eye. If you wear contacts, then you should skip using them until the eye symptoms are gone, and make sure you disinfect the lenses before you use them again.”
As for allergy-like symptoms, Dr. Russo says it “can be really hard” to tell the difference between signs of actual allergies and a COVID-19 infection. If you have a fever, that’s not allergies, he stresses, adding that you should also suspect COVID-19 if you don’t have a history of allergies but suddenly develop allergy-like symptoms.
When in doubt, “I would take a [COVID] test,” Dr. Schaffner notes.
Above all, the steady rise of XBB.1.16 is a reminder that COVID continues to wax and wane, even as we head into summer. “People want to put the pandemic behind them, but COVID hasn’t disappeared,” Dr. Schaffner says. “For the most part, it’s causing mild disease but we have to recognize that it’s still causing 200 to 300 deaths in the US each and every day. It’s still out there and spreading.”