As of 24 April 2020, over 2.8 million cases of Coronavirus disease 2019 (COVID-19) with ~200,000 deaths have been reported in 210 countries (https://www.worldometers.info/coronavirus/). Studies have shown that ~30% of the hospitalised patients with COVID-19—usually those who were older (mean age of 60–70 years) and with multiple systemic co-morbidities—require admission to intensive care units (ICUs) and ventilatory support [1,2,3]. While provision of the critical care service is crucial, it is important not to forget about the eye care in these critically ill patients.

Occurrence of ocular complications, particularly corneal infection (a potentially blinding condition), has been a recurrent theme for critically ill patients in ICUs [4]. Main predisposing factors include the inability to close the eyes causing exposure keratopathy, impaired blinking reflex, drying of ocular surface causing breakdown of corneal epithelium, contamination from the infected respiratory secretions, and intermittent positive-pressure from the ventilation causing venous stasis and conjunctival oedema [4]. This issue recently came to light where a patient with COVID-19 in our ICU, ventilated for several days, developed an exposure keratopathy with corneal abrasion, which was reported as ‘white cornea with presumed infection’. This was immediately reviewed by the ophthalmology team and prophylactic topical antibiotic medication was instituted. This underscores the importance of incorporating prevention, recognition, and management of eye problems as part of the care bundle of COVID-19.

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