When Ebola strikes, saving lives, stopping transmission and protecting health workers rightly become the immediate priorities.
But recovery from Ebola should not end when the virus is no longer detected.
The survivor’s sight must also be protected.
Uganda’s recent Ebola experience, including the 2026 outbreak, reminds us that preparedness must continue even after an outbreak is declared over.
The experience of Uganda and the Democratic Republic of Congo also highlights an important but sometimes overlooked issue: Ebola can affect the eyes, both during acute illness and after recovery.
As an eye care provider and a Lion committed to community service, I believe the public, caregivers, health workers and community leaders should know what to look for and how to respond.
How Ebola can affect the eyes
Ebola can affect many organs, including the eyes. During acute illness, patients may develop conjunctivitis (red eye) and subconjunctival haemorrhage, which is bleeding beneath the clear membrane covering the white part of the eye.
Some may experience visual disturbance.
Among survivors, however, more serious complications have been reported.
These include:
(a). Uveitis – inflammation inside the eye. It may cause pain, redness, excessive watering, blurred vision and marked sensitivity to light. Severe or untreated inflammation can damage vision permanently.
(b). Cataract – clouding of the normally clear lens inside the eye. The person may notice foggy or blurred vision, difficulty reading, recognizing faces or seeing in bright light. Cataract can be treated, including by surgery when appropriate.
(c). Glaucoma – damage to the optic nerve, sometimes associated with increased eye pressure. Inflammation can interfere with the normal drainage of fluid from the eye. Glaucoma may silently destroy vision, particularly peripheral vision, and established nerve damage cannot simply be reversed.
(d). Corneal opacity – scarring or clouding of the cornea, the transparent front “window” of the eye. It may cause pain, watering, light sensitivity and reduced vision. Severe scarring can cause permanent visual impairment.
(e). Retinal disease or retinopathy – changes or scars affecting the retina, the light sensitive layer at the back of the eye. Damage may cause blurred vision, difficulty reading, missing areas of vision, spots or shadows, and difficulty recognizing faces.
(f). Optic nerve problems – damage to the nerve connecting the eye to the brain can cause reduced vision even when the front of the eye appears relatively normal. These complications demonstrate that Ebola-related eye disease is far more than simple red eye.
The danger after recovery
One of the most important lessons from previous Ebola outbreaks is that eye disease may develop during recovery, after the patient appears to have recovered from the acute infection.
Studies and survivor programmes in West Africa and the Democratic Republic of Congo have documented uveitis, retinal abnormalities, dry eye disease, cataract and glaucoma among survivors.
Therefore, the question should not simply be, “Did this person survive Ebola?” We should also ask, “Can this survivor see well?”
Warning signs everyone should recognize
An Ebola survivor should be referred for professional eye assessment if there is
(a) New or persistent eye redness.
(b) Eye pain.
(c) Blurred or reduced vision.
(d) Increased sensitivity to light.
(e) Excessive watering or persistent irritation.
(f) Difficulty reading or recognizing faces.
(g) New floaters, flashes, spots or shadows.
(h) A white, grey or cloudy area on the front of the eye.
(i) Any sudden deterioration or loss of vision.
Sudden loss of vision is an eye emergency.
These symptoms should not simply be dismissed as weakness following Ebola.
A multidisciplinary responsibility
The first person to notice an eye problem may not be an ophthalmologist. It may be a nurse, doctor, clinical officer, community health worker, counsellor, teacher, parent, relative, friend, religious leader or caregiver at home.
Every stakeholder involved in Ebola preparedness and survivor care should therefore remain alert to visual complaints.
A survivor saying, “I cannot see properly,” “light hurts my eyes,” “my eye hurts,” “I am seeing spots,” or “I cannot read like before” deserves attention and referral.
The response should be recognition, referral and appropriate examination—not guesswork.
Steroid eye drops should not be started casually.Although steroids are important in treating some forms of eye inflammation, inappropriate use can worsen certain infections and cause complications such as increased eye pressure. Traditional substances, household remedies and unprescribed medicines should also not be put into the eye.
Protecting health workers
The eyes of health workers also require protection.
The conjunctiva is a mucous membrane and exposure to infected body fluids can present a potential route of infection.
Proper infection-prevention measures and appropriate personal protective equipment, including eye or face protection when indicated, are essential. Correct wearing, use and removal of protective equipment are equally important.
Protecting the health worker protects the family and the community.
What Uganda can do
Ebola survivor programmes should incorporate eye health rather than waiting for severe visual loss.
Uganda can strengthen this approach by:
- Asking survivors routinely about eye and vision symptoms.
- Establishing clear referral pathways between Ebola survivor services and eyecare facilities.
- Training frontline health workers and community health workers to recognize warning signs.
- Providing appropriate eye examination and follow-up for survivors with symptoms.
- Ensuring access to essential ophthalmic medicines, cataract surgery and other appropriate treatment.
- Recording and researching ocular complications among Ugandan survivors. g. Strengthening collaboration between infectious-disease specialists, ophthalmologists, optometrists, nurses, community health workers and rehabilitation teams.
- Using teleophthalmology where appropriate to support triage and specialist follow-up, especially for survivors far from eye hospitals.
What Lions and community organizations can do
As Lions, we have a particular responsibility because vision is one of the major areas of Lions humanitarian service.
Lions Clubs, faith-based organizations, schools, civil society organizations and other community groups can complement-not replace-government health services by:
- Educating communities about possible eye problems after Ebola.
- Encouraging survivors with visual symptoms to seek professional care early.
- Supporting referral and follow-up.
- Supporting safe, professionally supervised vision-screening activities. e. Helping people with permanent visual impairment access rehabilitation and low vision services.
- Using community meetings, radio, churches, schools and other trusted platforms to spread accurate information.
This is a practical expression of the Lions motto:
We Serve.
Why preserving sight matters
Vision is not merely about seeing.
A farmer needs vision to plant, weed and harvest.
A fisherman needs vision to work safely.
A driver needs vision to use the road.
A teacher and student need vision to read.
A trader needs vision to conduct business.
Parents and caregivers need vision to care for their families.
Preventing avoidable blindness after Ebola is therefore not only an ophthalmology issue.
It is a public-health, social, economic and humanitarian intervention.
The message to Uganda
Uganda’s Ebola experience demonstrates why preparedness must continue beyond the declaration that an outbreak is over.
Regional outbreaks, particularly in the Democratic Republic of Congo, remind us that vigilance, surveillance, early reporting, infection prevention and community cooperation remain essential. But preparedness must also include the survivor’s long-term health—including vision.
Let every health worker, caregiver, community leader and Lion remember: Ebola can affect the eyes.
Eye disease may appear after recovery.
Redness, pain, light sensitivity, watering, floaters and blurred or reduced vision should never be ignored.
Early professional eye examination can prevent avoidable visual disability. And when a survivor returns home, let us not only ask whether the person survived.
Let us ask whether the person can see.
Saving a life is an extraordinary achievement.
Helping that survivor retain or regain useful vision restores independence, productivity and dignity.
That is medicine.
That is public health.
That is humanitarian service. That is Lionism. (By Lion Edwin Niwagaba also Eye Specialist at Entebbe Central Clinic & Past President, Lions Club of Entebbe)
