OCULAR MANIFESTATIONS OF SYSTEMIC VIRAL INFECTIONS: A SYSTEMATIC REVIEW
Bibliographic record
Abstract
Background: Systemic viral infections can lead to a broad spectrum of ocular manifestations, which are often overlooked in clinical settings. Although previous reports have documented these associations individually for viruses such as SARS-CoV-2, Dengue, and Herpes simplex virus, a comprehensive synthesis comparing their ocular involvement is lacking. Objective: This systematic review aims to analyze and categorize the range of ocular complications associated with COVID-19, Dengue virus, and Herpes simplex virus infections, highlighting prevalence, clinical patterns, and implications for eye care. Methods: A systematic review was conducted in accordance with PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, and Cochrane Library for studies published between 2020 and 2025. Inclusion criteria comprised observational studies, cohort studies, and case series reporting ocular findings in patients with confirmed COVID-19, Dengue, or Herpes simplex virus infections. Data extraction included study design, sample size, type of ocular involvement, and prevalence. Risk of bias was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklist. Quantitative synthesis was conducted where applicable, and a forest plot was constructed for COVID-19-related findings. Results: Twelve studies met inclusion criteria, encompassing a range of ocular complications including conjunctivitis, episcleritis, retinal hemorrhages, maculopathy, and keratitis. COVID-19-related ocular symptoms showed prevalence rates ranging from 12% to 30%. Dengue and Herpes simplex virus were associated with more posterior segment and vision-threatening findings. A forest plot demonstrated variability in prevalence among COVID-19 cohorts. The strength of evidence varied, with some studies limited by small sample sizes and heterogeneity in diagnostic criteria. Conclusion: Ocular complications are increasingly recognized as clinically relevant manifestations of systemic viral infections. While most are self-limiting, others may cause significant visual morbidity. Findings underscore the need for routine ocular evaluation in affected patients and encourage future prospective studies to establish causality, long-term outcomes, and treatment protocols.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".