Oculoplastic management of patients in the Covid-19 era: experience from an Italian tertiary referral center

Ocular tropism of coronavirus (CoVs): a comparison of the interaction between the animal-to-human transmitted coronaviruses (SARS-CoV-1, SARS-CoV-2, MERS-CoV, CoV-229E, NL63, OC43, HKU1) and the eye

“…Ophthalmologists were alleged to be among the highest risk subspecialties susceptible to contract the infection due to the face-to-face proximity during slit-lamp biomicroscopy examination, direct and indirect ophthalmoscopy which highly expose them to aerosolized particles [ 74 ]. Therefore, a disinfection protocol was advised in clinic settings to clean potentially contaminated surfaces like slit lamps, lenses and Goldman tonometer tips using 70% alcohol-based wipes that are effective against coronaviruses, unlike adenoviruses that are more resistant to these alcohol-based disinfectants [ 75 ].…”

“…Along with curfew and travel restrictions mandated globally, nonurgent and elective ophthalmology clinic appointments and operations are being postponed, especially for elderly and patients with comorbidities who are at increased risk of severe disease [ 63 , 74 , 76 ]. The CDC also recommended delaying all elective ambulatory provider visits, rescheduling elective and nonurgent admissions and procedures.…”

“…A well-equipped special clinic with a separate waiting area is mandated if appointment is urgent [ 63 ]. Other measures advised by many medical societies include the following: limiting the number of patients’ companions, noncontact temperature measurement before entering the health institute, spacing out patients’ appointments to minimize clustering in the waiting hall and social distancing; these are all measures taken and advised by many health societies [ 62 , 63 , 73 , 74 ]. Telemedicine is also gaining popularity among the different medical specialties to minimize the risk of exposure for both patients and healthcare workers.…”

“…• Postpone any nonurgent ophthalmic issues until this outbreak is under control • Follow the standard precautions, including hand hygiene and eye/nose/mouth protection, when dealing with patients with urgent ophthalmic conditions but no symptoms suggestive of COVID-19 • Employ extra precautions for patients with urgent ophthalmic conditions and respiratory symptoms only such as goggles, face shield, gloves, surgical mask or N-95 mask if an aerosol-generating procedure will be performed, masking the patient, immediate attendance to the patient and disinfection of the room after the patient departs • Treat patients with suspected or confirmed COVID-19 and concurrent urgent ophthalmic conditions in a hospital setting with firm compliance with the CDC and/or hospital precautionary guidelines for care of these patients Along with curfew and travel restrictions mandated globally, nonurgent and elective ophthalmology clinic appointments and operations are being postponed, especially for elderly and patients with comorbidities who are at increased risk of severe disease [63,74,76]. The CDC also recommended delaying all elective ambulatory provider visits, rescheduling elective and nonurgent admissions and procedures.…”

“…In order to further minimize exposure among healthcare workers in ophthalmic institutes, some facilities are advocating assigning healthcare providers into smaller groups with different working hours' shifts and schedules. This certainly facilitates proper tracing and isolation among these smaller clusters in case asymptomatic infected individuals were detected [64,74]. When exposure to a suspected COVID-19 patient does occur, healthcare workers are instructed to report immediately to the infection control personnel and isolate themselves at home away from other family members while monitoring themselves for any symptoms.…”