DOCS can tell if you’re suffering from long Covid by looking in your eyes, a remarkable study has found.
Many people with the condition may not have a formal diagnosis because they don’t have proof of a positive Covid test.
But an eye examination may become a useful new tool to spot those who are so-called “long haulers”.
Researchers led by Gulfidan Bitirgen from Necmettin Erbakan University in Turkey looked at nerve damage in the cornea – a clear dome over the front of the eye that protects the pupil and iris.
Changes in the cornea have been seen in many other diseases, such as diabetes, multiple sclerosis, and fibromyalgia.
Nerve damage in the cornea can be detected by a non-invasive laser technique called corneal confocal microscopy (CCM).
The researchers used CCM to look into the area of 40 people who had previously had a positive Covid test, and 30 healthy people who had not.
Coronavirus survivors were quizzed on their persistent symptoms to gauge the severity of their “long Covid”.
The study claimed that the patients who reported having persistent coronavirus symptoms had a higher level of corneal nerve fiber damage and loss.
These patients also had increased dendritic cells (DC), a type of immune system cell.
There was a clear link between the total score on the long Covid severity quiz, ranging from zero to 26, and damage to the cornea nerves.
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Prof Bitirgen wrote in the paper: "To the best of our knowledge, this is the first study reporting corneal nerve loss and an increase in DC density in patients who have recovered from Covid-19, especially in subjects with persisting symptoms consistent with long Covid.
“These findings are consistent with an innate immune and inflammatory process characterised by the migration and accumulation of DCs in the central cornea in a number of immune mediated and inflammatory conditions.
“Corneal confocal microscopy may have clinical utility as a rapid objective ophthalmic test to evaluate patients with long Covid.”
The researchers said there are now a number of studies that suggest Covid can damage or disease nerves, called peripheral neuropathy.
The peripheral nervous system is the network of nerves that lie outside the central nervous system (the brain and spinal cord).
In the UK diabetes (both type 1 and type 2) is the most common cause of peripheral neuropathy, as over time high blood sugar levels cause the nerves to deteriorate.
Alongside a number of problems such as numbness in the feet, muscle cramps, and excessive sweating, peripheral neuropathy can cause double vision or other problems with focusing your eyes, sometimes with eye pain.
The findings were reported in British Journal of Ophthalmology.
Long Covid is usually diagnosed on the NHS after ruling out any other potential causes of symptoms.
If someone goes to their GP complaining of persistent symptoms such as fatigue or headaches, their doctor may do blood tests, check blood pressure or heart rate or refer for a chest X-ray.
The NHS says the doctor may give advice about how to “manage” the symptoms at home, or refer to a specialist service.
A network of specialist NHS long Covid clinics were set up last year when it was realised the severity of the problem in the UK.
Currently it is estimated by the Office for National Statistics that one million people are suffering from long Covid – defined as four weeks after coronavirus infection.
Of these, 385,000 said they believed or were confirmed to have the virus at least a year ago.
However, research has found just one per cent of people who have had long Covid in the past 18 months never got a formal diagnosis with their GP.
More than a quarter of GP practices had never logged a case, according to the article in the British Journal of General Practice, despite the problem being rife.
The survey from ONS suggests 634,000 people may need treatment because their condition “adversely affects their day-to-day activities”.
Those plagued with long Covid most commonly battle fatigue, brain fog and breathlessness.
But as researchers pointed out earlier this month, there are at least 200 problems being reported by long haulers.
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