The Transmission of Infection Through the Eye

Maxcy, Kenneth F.

doi:10.1001/jama.1919.02610090020005

Cited by 22 publications

(13 citation statements)

References 2 publications

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“…The potential effectiveness of eye protective gear for infection control was pointed out over 100 years ago [1], but this simple intervention has received limited attention during the ongoing pandemic, except as part of Personal Protective Equipment (PPE) for health care workers.…”

Section: Background and Rationalementioning

confidence: 99%

The GLasses Against transmission of SARS-CoV-2 in the communitY (GLASSY) trial: A pragmatic randomized trial (study protocol)

Fretheim

Hemkens

Helleve

et al. 2022

Preprint

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Background: A systematic review of observational studies indicated that eye protection may be an effective measure to prevent SARS-CoV-2 infections. Randomized trials are needed to assess whether the observed associations are caused by protection of the eye or confounding factors such as other systematic differences between users and non-users of eye protection, co-interventions, or changes in COVID-19 incidence when comparisons were done over time. Methods: Pragmatic, virtual, parallel group, 1:1 randomized, superiority trial. We will recruit and randomize participants via an online portal. The trial will be fully remote and virtual without any personal interaction between investigators and participants. All members of the public are eligible who confirm that they are at least 18 years of age, do not regularly wear glasses, have not contracted COVID-19 since December 15th 2021, and are willing to be randomized to wear, or not wear glasses in public when close to other people, for a 2-week period. Persons who are dependent on visual aids but typically use contact lenses are eligible. The participants will be randomized (1:1) to wear glasses (sunglasses or other types of glasses) in public spaces when close to others (public transport, shopping centers etc.), or to the control group. The control group will be asked not to wear glasses in public spaces when close to others. The primary outcome is positive test for COVID-19. We aim to include about 25,000 participants to have a statistical power of 80% to detect a relative risk reduction of 25% for the primary outcome. Discussion: Many have easy access to sunglasses or other glasses. Wearing glasses may provide eye protection and repurposing sunglasses for infection control could be a simple, readily available, environmentally friendly, safe, and sustainable infection prevention measure.

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Section: Background and Rationalementioning

confidence: 99%

The GLasses Against transmission of SARS-CoV-2 in the communitY (GLASSY) trial: A pragmatic randomized trial (study protocol)

Fretheim

Hemkens

Helleve

et al. 2022

Preprint

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show abstract

“…In 1919, Maxcy carried out a second set of remarkable experiments using B. prodigiosus in a paper entitled "The transmission of infection through the eye". 12 This was carried out at the time of the third wave of the Spanish flu pandemic, and in the introduction to his paper, Maxcy stated that: "Recently the eye has received little or no attention as a factor in the transmission of acute respiratory infections. It has been disregarded in planning measures for the prevention of the spread of contagious diseases.…”

Section: ■ Your Doctor Needs Goggles: You Do Toomentioning

confidence: 99%

“…This was especially true in the recent epidemic of influenza". Maxcy then calculated the relative importance of eye, nose, and mouth exposure to direct droplet spray (including estimates of the effect of blinking, expiration/air currents, and talking) and concluded that there was a 600 mm 2 area of eye exposure but only 100 mm 2 for the nose and very little for mouth exposure 12 . Building on the work of Doust and Lyon, Maxcy then instilled B. prodigiosus into one eye in each of five subjects.…”

Section: ■ Your Doctor Needs Goggles: You Do Toomentioning

confidence: 99%

COVID-19 and Other Pandemics: How Might They Be Prevented?

Oldfield

Malwal

2020

ACS Infect. Dis.

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Pandemics such as influenza, smallpox, and plague have caused the loss of hundreds of millions of lives and have occurred for many centuries. Fortunately, they have been largely eliminated by the use of vaccinations and drugs. More recently, Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and now Coronavirus Disease 2019 (COVID-19) have arisen, and given the current absence of highly effective approved vaccines or drugs, brute-force approaches involving physical barriers are being used to counter virus spread. A major basis for physical protection from respiratory infections is eye, nose, and mouth protection. However, eye protection with goggles is problematic due to “fogging”, while nose/mouth protection is complicated by the breathing difficulties associated with non-valved respirators. Here, we give a brief review of the origins and development of face masks and eye protection to counter respiratory infections on the basis of experiments conducted 100 years ago, work that was presaged by the first use of personal protective equipment, “PPE”, by the plague doctors of the 17th Century. The results of the review lead to two conclusions: first, that eye protection using filtered eye masks be used to prevent ocular transmission; second, that new, pre-filtered, valved respirators be used to even more effectively block viral transmission.

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“…The combined experimental and clinical data recorded by a number of investigators (e.g., Rosenow, 1912Rosenow, , 1919Davis, 1912;Billings, 1914;Irons, 1921Irons, , 1924Haden, 1925) enable us to assume that focal infections offer ample opportunity for the penetration of bacteria into the blood circulation of apparently healthy animals, and the same assumption may hold for other possible portals of entry (Garr6, 1885;Manfredi, 1899;Thiele and Embleton, 1913-14;Maxcy, 1919;Strauss, 1924).…”

Section: Review Of the Literaturementioning

confidence: 99%

Bacteria in Muscular Tissues and Blood of Apparently Normal Animals

Reith¹

1926

JAMA

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The Transmission of Infection Through the Eye

Cited by 22 publications

References 2 publications

The GLasses Against transmission of SARS-CoV-2 in the communitY (GLASSY) trial: A pragmatic randomized trial (study protocol)

The GLasses Against transmission of SARS-CoV-2 in the communitY (GLASSY) trial: A pragmatic randomized trial (study protocol)

COVID-19 and Other Pandemics: How Might They Be Prevented?

Bacteria in Muscular Tissues and Blood of Apparently Normal Animals

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