Minas Theodore Coroneo, Peter John Collignon
m.coroneo@unsw.edu.au
Department of Ophthalmology, University of New South Wales at Prince of
Wales Hospital, Randwick, NSW 2031, Australia (MTC); Department of Infectious
Diseases and Microbiology, Canberra Hospital, Garran, ACT, Australia (PJC);
Department of Infectious Disease, Medical School, Australian National
University, Acton, ACT, Australia (PJC)
Remarkably, a year after the COVID-19 outbreak, we
remain ineffectual against widespread community
infection. Perhaps, something major is missing in our
approach?
The importance of aerosols versus droplets1 is debated—
most viral transmission appears to be via virus-laden
droplets, with the greatest risk in crowded, inadequately
ventilated environments. Proximity to those infected
poses the greatest risk. Currently, the presumed major
viral invasion modalities involve inhalation or hand
contamination of mucosal surfaces, despite studies to the
contrary from a century ago2 showing the importance of
eyes as an influenza infection route. Ocular surface droplet
deposition is greatly underappreciated as a probable,
frequent route for SARS-CoV-2 transmission.