COVID-19: Special Precautions in Ophthalmic Practice and FAQs on Personal Protection and Mask Selection

Abstract

The Coronavirus Disease 2019 , caused by severe acute respiratory coronavirus-2, was first reported in December 2019. The World Health Organization declared COVID-19 a pandemic on March 11, 2020 and as of April 17, 2020, 210 countries are affected with >2,000,000 infected and 140,000 deaths. The estimated case fatality rate is around 6.7%. We need to step up our infection control measures immediately or else it may be too late to contain or control the spread of COVID-19. In case of local outbreaks, the risk of infection to healthcare workers and patients is high. Ophthalmic practice carries some unique risks and therefore high vigilance and special precautions are needed. We share our protocols and experiences in the prevention of infection in the current COVID-19 outbreak and the previous severe acute respiratory syndrome epidemic in Hong Kong. We also endeavor to answer the key frequently asked questions in areas of the coronaviruses, COVID-19, disease transmission, personal protection, mask selection, and special measures in ophthalmic practices. COVID-19 is highly infectious and could be life-threatening. Using our protocol and measures, we have achieved zero infection in our ophthalmic practices in Hong Kong and China. Preventing spread of COVID-19 is possible and achievable.

Impact of COVID-19 Pandemic on Young Ophthalmologists in Cairo University Hospitals

“…Moreover, the COVID-19 present in tears is a source of cross infection. 6 Although 55.8% of our candidates feel unlucky starting ophthalmic practice during this era, only 11.4% regret being Ophthalmologists and 19% regret being physicians. This explains why 7.6% are extremely anxious regarding their psychological concern about the pandemic, and some feel they need psychological assessment especially those with 1-3 years duration of practice (41.2%) (p = .011), especially females (82.4%, p = .015) Also 73.4% of these young ophthalmologists encounter pressure from their relatives on going to work because they are concerned about conducting infection.…”

Ocular manifestations of emerging viral diseases

“…Eye specialists are at particular risk due to the close proximity during eye examination and the potential for ‘air puff’ tonometry to generate droplets or aerosols [ 227 ]. General precautions in ophthalmic practice includes installation of transparent shields on slit-lamps, disinfection of surfaces and instruments after each use, donning of protective equipment, appropriate triaging and implementation of telemedicine where appropriate [ 228 , 229 ]. Given the variations in practice patterns, practitioners should heed their respective best-practice guidelines for infection control.…”

COVID-19: Ocular Manifestations and the APAO Prevention Guidelines for Ophthalmic Practices

“…Commercially available or custom-made slit lamp breath shield 28 , 29 can be installed on each slit lamp to reduce 46% to 97% of the overspray from a simulated sneeze. Breath shields of comparable sizes mounted more anteriorly at the objective arm are more effective than those hung posteriorly at the oculars.…”