Overall, nerve and muscle ultrasound is a valid and reliable diagnostic imaging technique.

Introduction Neuromuscular ultrasound is valid, reliable, and accurate, but it is not known if combining it with electrodiagnostic studies leads to better outcomes in individuals with focal neuropathies. Methods 120 individuals with focal neuropathy based on history, examination, and electrodiagnosis were enrolled. All underwent neuromuscular ultrasound and were randomized to either have their ultrasound results sent to the referring physician or not. Outcomes were assessed at 6 months by evaluators blinded to group assignment. Results The Overall Disability Sum Score and 7 of 8 domains of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) showed more improvement in the “report sent” group, though only the general health perception domain was significant (P = 0.005). Conclusions Most 6-month outcomes did not reach statistical significance between the 2 groups. However, the “report sent” group had trends toward better outcomes with significance reached in the general health perception domain of the SF-36.

Purpose: To quantify aerosol and droplets generated during noncontact tonometry (NCT) and assess the spread distance of the same. Methodology: This was an experimental study on healthy human volunteers (n=8 eyes). In an experimental setup, NCT was performed on eyes (n=8) of human volunteers under normal settings, with a single and 2 drops of lubricant. High-speed shadowgraphy, frontal lighting technique, and fluorescein analysis were used to detect the possible generation of any droplets and aerosols. Mathematical computation of the spread of the droplets was then performed. Results: In a natural setting, there was no droplet or aerosol production. Minimal splatter along with droplet ejection was observed when 1 drop of lubricant was used before NCT. When 2 drops of lubricant were instilled, a significant amount of fluid ejection in the form of a sheet that broke up into multiple droplets was observed. Some of these droplets traversed back to the tonometer. Droplets ranging from 100 to 500 µm in diameter were measured. Conclusions: There was no droplet generation during NCT performed in a natural setting. However, NCT should be avoided in conditions with high-tear volume (natural or artificial) as it would lead to droplet spread and tactile contamination.

Purpose: To study propensity of aerosol and droplet generation during phacoemulsification using high-speed shadowgraphy and quantify its spread amid COVID-19 pandemic. Setting: Aerosol and droplet quantification laboratory. Design: Laboratory study. Methods: In an experimental set-up, phacoemulsification was performed on enucleated goat eyes and cadaveric human corneoscleral rims mounted on an artificial anterior chamber. Standard settings for sculpt and quadrant removal mode were used on Visalis 100 (Carl Zeiss Meditec AG). Microincision and standard phacoemulsification were performed using titanium straight tips (2.2 mm and 2.8 mm in diameter). The main wound incisions were titrated equal to and larger than the sleeve size. High-speed shadowgraphy technique was used to detect the possible generation of any droplets and aerosols. The visualization and quantification of size of the aerosols and droplets along with calculation of their spread were the main outcome measures. Results: In longitudinal phacoemulsification using a peristaltic pump device with a straight tip, no aerosol generation was seen in a closed chamber. In larger wounds, there was a slow leak at the main wound. The atomization of balanced salt solution was observed only when the phacoemulsification tip was completely exposed next to the ocular surface. Under this condition, the nominal size of the droplet was approximately 50 µm, and the maximum calculated spread was 1.3 m. Conclusions: There was no visible aerosol generation during microincision or standard phacoemulsification. Phacoemulsification is safe to perform in the COVID-19 era by taking adequate precautions against other modes of transmission.