MADURAI/PUDUCHERRY: Ophthalmologists have urged diabetic patients to watch out for eye infections as mucormycosis, a rare but dangerous fungal infection, is being reported among the uncontrolled diabetic COVID-19 patients in recent times.
Addressing the media persons on Friday, Dr Usha Kim, chief of Department of Orbit, Oculoplasty, Ocular Oncology and Ocular Prosthetics at Aravind Eye Hospitals, said that Mucormycosis (a.k.a Black fungus infection) is a serious, rare, and fatal fungal infection. This condition has been existing in patients with diabetes and weak immune system.
"But now, this has been on the rise alongside COVID-19. The number of cases that we used to see in a year (12 cases per year on an average) at Aravind Eye Hospital, Madurai, is seen in a week now. One common thread among all such patients is that they are all diabetic with uncontrolled blood sugar levels. They are found to be COVID-positive after they report here with eye infections," Usha noted.
Similar is the case with Puducherry, where 12 cases have been reported in the last weeks. In all these patients, the infection had spread to the eye, which is third stage (late stage) of the disease, that starts in nose and spreads to sinus and then to the eye, said Dr R Venkatesh, chief medical officer, Aravind eye Hospital, Puducherry.
Unfortunately, five of them have lost vision in one eye. They need ENT and neuromanagement and so they have been referred to JIPMER and multi-specialty hospitals with ENT and neuro team support for management in Chennai.
The prognosis of all these 12 are not known as they have been referred to multi-specialty hospitals. "Only when the infection is in the nose, we can prevent catastrophic complications like blindness and death," he said.
What is mucormycosis (black fungus)
Mucormycosis is caused by a group of moulds called mucormycetes that usually are found throughout the natural environment. It often affects the sinuses, lungs, skin, and brain.
Why does it affect COVID-19 patients
Patients with uncontrolled diabetes are known to be at high risk of contracting COVID. When this happens, they are treated with steroids which further compromises their immunity. Doctors in India hold that steroids, which are used as a life-saving treatment for severe and critically ill COVID patients, can prove to be a trigger for mucormycosis.
While steroids help in reducing inflammation in lungs, they can also decrease immunity and increase blood sugar levels in both diabetics and non-diabetic covid-19 patients alike
Alerting signs and symptoms
Pain or redness in and around the eyes
Facial or hemi-facial pain
Discolouration around the eye
Sudden loss of vision
Swelling in the eye
Forward protrusion of the eyeball
Absence of eye ball movement
Paralysis to the nerves supplying to muscles of the eye
Black eschar
Nasal stuffiness, discharge or bleed from the nose
Precautions to be taken
COVID-19 patients should control hyperglycemia by regularly monitoring their blood glucose level post discharge. Diabetics should also monitor their blood glucose levels.
Treatment for mucormycosis
Patients should control diabetes and diabetic ketoacidosis. Doctors should reduce steroids in case the patient is still on them and discontinue rapidly. Immunomodulating drugs should also be discontinued.