Ophthalmologists must adopt Infection control measures during COVID-19 outbreak

01 Apr 2020
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Ophthalmologists are advised to cooperate with local infection control teams in the implementation of infection control measures that are appropriate for their clinical settings in order to minimize the transmission of coronavirus disease 2019 (COVID-19), suggests a Hong Kong study.

The authors discussed current infection control measures being implemented in their ophthalmology clinic. The basis of these measures was the detailed risk assessment by both local ophthalmologists and infection control experts.

Three levels of control measures were adopted. First, for administrative control, patient attendance was reduced by sending text messages with an enquiry phone number to patients so they could reschedule appointments or arrange drug refill. To lessen cross-infection of COVID-19, a triage system was established to identify patients with fever, respiratory symptoms, acute conjunctivitis or recent travel to outbreak areas, as well as to encourage individuals to postpone their appointments for at least 14 days.

The following procedures were also avoided: micro-aerosol generating procedures, such as noncontact tonometry, operations under general anaesthesia, and nasal endoscopy (as this may provoke sneezing and cause generation of droplets). All elective clinical services were suspended as well. In addition, all clinical staff underwent infection control training.

Second, for environmental control, droplet transmission of COVID-19 was reduced by installing protective shields on slit lamps, frequently disinfecting equipment and providing eye protection to staff. All frontline workers were also advised to measure their body temperatures before work and promptly report any symptoms of upper respiratory tract infection, vomiting or diarrhoea.

Third, the following practices were promoted: hand hygiene, universal masking, and appropriate use of personal protective equipment.

“We hope our initial experience in stepping up infection control measures for COVID-19 infection in ophthalmology can help ophthalmologists globally to prepare for the potential community outbreak or pandemic,” the authors said.

COVID-19 started in Wuhan, China, in December 2019 and spread across the globe partially due to alleged censure of disease outbreak and delayed institution of travel restrictions to and from the city. It has infected more than 715,000 individuals, with almost 34,000 deaths, as of this writing.

Graefes Arch Clin Exp Ophthalmol 2020;doi:10.1007/s00417-020-04641-8