Managing ocular complications
One discovery from this case that will be useful in managing the ocular complications of EVD was that conjunctival and tear film samples taken both before and after the anterior chamber paracentesis tested negative for the virus.
This has implications for the clinical examination of Ebola survivors from an infection control and precaution guidance standpoint, but more invasive procedures are still being vetted in terms of the right way to proceed for ophthalmologists abroad,” Dr. Yeh said.
“The prevalence of the persistence of the Ebola virus in intraocular fluid is still unknown,” he said. “Further study is needed.”
Emory physicians seized the opportunity of this unprecedented case to launch research and outreach efforts. During the critical treatment stages, they were unsure whether the case was an outlier or whether other Ebola patients and survivors had similar complications.
“We looked in the literature and found some case reports of Ebola-associated uveitis, so we thought this might be a real problem,” said Dr. Shantha, who was then an ophthalmology resident and is currently a medical retina fellow at the Retina Consultants of Hawaii.
“We started to reach out to various ophthalmic non-governmental organizations in Liberia and Sierra Leone to see if anyone had seen this aggressive sight-threatening panuveitis, but also, as Dr. Crozier got better, we thought that the lessons we learned could be translated and help with the care of survivors in West Africa,” Dr. Shantha said.