Guidelines of the Polish Ophthalmological Society on how to deal with ophthalmic patients during the COVID-19 epidemic

Abstract

SARS-CoV-2 is a coronavirus that causes COVID-19 disease (coronavirus disease 2019). The viral particle contains single-stranded RNA composed of approximately 30 thousand nucleotides, and has a diameter of 60-140 nm, which makes it one of the largest RNA viruses [1]. The virus spreads through droplets. The incubation period is 1-14 days (approx. 5-7 days from exposure to symptom appearance) [2]. Its presence may be detected in secretions from the nose, throat, blood, sputum, stool, and tears. The first reports mentioning infections with the virus came from Wuhan in China (November 2019) [3]. Symptoms of the infection include, first and foremost, cough and fever (Table I). The virus has a predilection for the re-* Guidelines of scientific societies and associations (including the Polish Ophthalmological Society) do not constitute binding laws and do not determine the only correct procedures; they are only an opinion of a group of experts from a given field. The opinion reflects the current state of knowledge based on available scientific research results. The guidelines do not exempt healthcare workers from personal liability with regard to making the correct decisions for individual patients. Personal responsibility for the used therapeutic methods rests with all individuals who practise medicine. It should be based on thorough knowledge and practical skills, while observing necessary safety measures with regard to oneself and the patient. Readers of this paper are obliged to make themselves familiar with current information on the presented treatments and pharmacotherapies with special attention paid to manufacturers' information on doses, time, and administration as well as side effects of the used drugs. The publishers and editors of the paper shall not be responsible for any damages that could in any way be connected to the contents of this paper.

The implication of ocular manifestation of COVID-19 for medical staff and patients – systematic review

“…Eye protection (goggles) or facial protection (face mask) should be worn, and healthcare workers are advised against touching any mucosal membranes (eyes, nose or mouth) [44]. Likewise, national ophthalmological societies, including the Polish Ophthalmological Society, announced recommendation/ guidelines on how to deal with an ophthalmic patient during the COVID-19 epidemic [45]. Basically, there are three-pronged strategies: protecting staff with appropriate PPE, preventing spread of the virus from patients, and re-arrangement of workflow to minimise exposure time and/or risk of cross-infections.…”

Ocular manifestations in SARS-CoV-2 infection and pre-exposure prophylaxis of ophthalmic medical staff

“…Universal exposure prophylaxis agents, including recommended infection prevention strategies, should be followed at the time of ophthalmic examination, and new COVID-19-targeted policies should be followed, consistent with guidelines from the AAO, Polish Ophthalmological Society (PTO), and other national scientific societies [52,53].…”

“…Special care should be taken during the ophthalmic examination because of the close distance between the examining physician and the patient's face. For this reason, the Societies recommend the use of N95 or better protective masks by ophthalmologists and physicians providing ophthalmic care for all patients, not only those potentially infected with SARS-CoV-2 [52,53]. In 2020, a meta-analysis was published on the optimal distance to protect against SARS-CoV-2 transmission and the effectiveness of using masks and eye protection in preventing coronavirus infection [54,55].…”

“…It is recommended to disinfect medical devices between the subjects with chemicals that do not interact with the materials they are made from. The most common disinfectants for use on optical surfaces are sodium hypochlorite and 70% alcohol or isopropyl alcohol (IPA), which is characterized by excellent evaporation as well as excellent cleaning and degreasing properties on a variety of surfaces [52,53].…”

SARS-CoV-2 and the Eyes: A Review of the Literature on Transmission, Detection, and Ocular Manifestations

“…Due to the significant risk of contracting SARS-CoV-2 in ophthalmology practice, numerous guidelines for management of ophthalmic patients in times of COVID-19 pandemic have been developed [ 20 – 22 ]. Limiting procedures requiring close doctor-patient contact to the necessary minimum is suggested, as well as maintaining physical distance between patients and disinfection of hands, surfaces, and equipment.…”