en Ophtalmology Ophtalmology Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#0033ff;"><strong><em>Background</em></strong><em>:</em> </span>The ocular symptoms are common manifestations in coronavirus infectious disease 2019 (COVID-19), which faces secondary complications and therapeutic challenges. Underlying diseases actuate the body to infectious diseases and their related manifestations through the aberration of metabolism and suppressing the immune system. This study aimed to investigate the correlation of underlying diseases and ocular manifestations in COVID-19 patients.<br> <span style="color:#0033ff;"><strong><em>Methods</em></strong><em>:</em> </span>This cross-sectional study was held on 108 hospitalized COVID-19 patients (confirmed by molecular detection) admitted to Rouhani hospital, Babol, Iran. Upon hospitalization, all clinical symptoms and underlying diseases were registered. Detailed clinical examinations regarding ophthalmological protocols were used to investigate the ocular symptoms. All analyses were performed by SPSS, version 25.<br> <span style="color:#0033ff;"><strong><em>Results</em></strong><em>:</em></span> Our results showed that 26.67% of patients with at least one ocular symptom had hyperlipidemia, while 10.42% of patients without any ocular symptoms had hyperlipidemia (P=0.049). In this study, 97.81% of COVID-19 patients without epiphora had no thyroid disorders (hyper-/hypo-thyroidism), while 82.35% of COVID-19 patients with epiphora had not any thyroid disorders (P=0.012). Also, 75.00% of patients with blurred vision had diabetes mellitus, while 35.00% of patients without blurred vision suffered from diabetes mellitus. This difference was borderline significant (P=0.051). Other results showed that 13.04% of COVID-19 patients with eye redness suffer from myalgia, while 35.29% of patients without eye redness had myalgia (P=0.044). Also, 35.11% of COVID-19 patients without photophobia had myalgia, while <s>no one</s> none of the patients with photophobia had myalgia (P=0.005). Finally, 70.00% of patients with respiratory distress had at least one ocular symptom, while 43.10% of patients without respiratory distress had at least one ocular symptom (P=0.007).<br> <span style="color:#0033ff;"><strong><em>Conclusion</em></strong><em>:</em></span> Some underlying diseases, e.g., hyperlipidemia, diabetes mellitus, and thyroid disorders, and some clinical symptoms in hospitalized patients, e.g., myalgia and respiratory distress, are correlated with ocular manifestations in COVID-19 patients.</span></span> Ocular manifestations, COVID-19, Epiphora, Blurred vision, Eye redness, photophobia 180 186 http://caspjim.com/browse.php?a_code=A-10-2197-1&slc_lang=en&sid=1 Mansour Babaei m.babaei@mubabol.ac.ir 100319475328460035770 100319475328460035770 No Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Masomeh Bayani bayani1@yahoo.com 100319475328460035771 100319475328460035771 No Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Maral Farzin 100319475328460035772 100319475328460035772 No School of Medicine, Babol University of Medical Sciences, Babol, Iran Seyed Ahmad Rasoulinejad seyedahmadrasoulinejad@gmail.com 100319475328460035773 100319475328460035773 Yes Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran