Re: Seah et al.: Assessing viral shedding and infectivity of tears in Coronavirus disease 2019 (COVID-19) patients (Ophthalmology. 2020;127:977-979)

Min, Jinjin; Qin, Qiyu; Jin, Xiuming

doi:10.1016/j.ophtha.2020.05.040

Cited by 5 publications

(4 citation statements)

References 4 publications

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“…Our study also reported more prevalence among patients with ocular symptoms on CPAP, as air leaks from the CPAP mask, due to poorly fitting mask, resulted in quick drying of the eye surface and ocular discomfort 7 , which may mimic the symptoms of viral conjunctivitis (red eye, watery discharge, burning, and itching) 15 , 18 , 28 , 29 .…”

Section: Discussionsupporting

confidence: 52%

Ocular manifestations in COVID-19 infections: a case series

Khalayli,

Haider,

Hodifa

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction: The prevalence of ocular abnormalities of COVID-19 is different according to different reports. However, currently available evidence on the presence of this virus in ocular secretions and its association with conjunctivitis is not well established. Objective: To reveal the ocular features among COVID-19 patients and to describe them with the findings of clinical data, inflammatory markers, and respiratory support therapy. Methods: Ocular symptoms were evaluated and recorded in 494 COV19 patients through questionnaire-style interviews, and an ophthalmologic examination. Data including age, sex, disease severity, and nasopharyngeal swab results were collected. Laboratory test values were reviewed. Patients with COVID-19 infections were classified into severe cases and mild cases. Results: The prevalence of ocular features was (2.83%). The most common features were conjunctival hyperaemia, epiphora, and foreign body sensation with itching. Patients with ocular manifestations on CPAP support therapy had higher rates of itching, lower rates of foreign body sensation. No differences were found in the levels of inflammatory marker. Meanwhile, patients used respiratory-aid therapy revealed higher values of white blood cells, platelet counts, erythrocyte sedimentation rate, C-reactive protein, ferritin, and lactate dehydrogenase. Discussion: Ocular involvement in COVID-19 and possibility of disease transmission through ocular tissues and secretions, has been registered in some reports, with a prevalence of 2–32%. The external and internal ocular parts are involved. Conclusion: Ocular features are not infrequent in COVID-19 patients.

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Section: Discussionsupporting

confidence: 52%

Ocular manifestations in COVID-19 infections: a case series

Khalayli,

Haider,

Hodifa

et al. 2023

Annals of Medicine &Amp; Surgery

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“…COVID-19 viral loads can be high in both symptomatic and asymptomatic patients, 14 suggesting universal precautions should be taken at the slit lamp regardless of whether patients are symptomatic, although the risk of ocular transmission of infection from tears of patients without conjunctivitis is purported to be low. 15 Patients are advised to no longer talk during slit lamp examinations. Examiners may be especially vulnerable when patients hyperventilate, cough, or sneeze at the slit lamp.…”

Section: Ophthalmologists May Be the Initial Caregivers Formentioning

confidence: 99%

Efficacy of Slit Lamp Breath Shields

Liu

Wang

Ing

2020

American Journal of Ophthalmology

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To evaluate the efficacy of slit lamp breath shields to prevent droplet spray from a simulated sneeze.DESIGN: Experimental study to test the effectiveness of personal protective equipment.METHODS: The nozzle of a spray gun was adjusted to angularly disperse a mist of colored dye that approximated a patient sneezing on a dimensionally accurate cardboard slit lamp model. The designs of 6 commercially available breath shields and 1 breath shield repurposed from a plastic container lid were tested. Each breath shield was sprayed in a standardized fashion 3 times, and the amount of overspray was compared to spray with no shield and quantified. The surface area that was sprayed was calculated using a commercially available software with color range function. The average percentage of overspray of each breath shield was computed in comparison to the control.RESULTS: The breath shields ranged in surface area from 116 to 924 cm 2 , and the amount of overspray varied from 54% to virtually none. Larger breath shields offered better protection than smaller ones. Breath shields attached to the objective lens arm were better barriers than those of comparable size hung by the oculars. A repurposed plastic lid breath shield, 513 cm 2 , was slightly curved toward the examiner's face and allowed only 2% overspray. The largest breath shield (924 cm 2 ) hung near the oculars and prevented essentially all overspray.CONCLUSIONS: The performance of different designs of breath shields was variable. Even high-functioning shields should be used in conjunction with personal protective equipment including masks, goggles, and gloves and handwashing. Ideally patients should also wear a face mask during all slit lamp examinations.

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“…Various parts of the patient's face touch most of the ophthalmic equipment, thus increasing the risk of spread of infection through aerosolized particles from respiratory droplet and contact [7] . There are also reports of SARS-CoV-2 identified in tears and conjunctival swabs, thus putting ophthalmologists at risk of acquiring the infection [8][9][10][11][12] . Guidelines have already been developed for ophthalmologists by the American Academy of Ophthalmology (AAO) [13] , International Council of Ophthalmology (ICO) [14] as well as different National Societies such as All India Ophthalmological Society (AIOS) [15] .…”

Section: Introductionmentioning

confidence: 99%

Response of L V Prasad Eye Institute to COVID-19 outbreak in India: experience at its tertiary eye care centre and adoption to its Eye Health Pyramid

et al. 2021

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AIM: To summarize the experience of response to COVID-19 outbreak at a tertiary eye care institute and its network of health facilities in India. METHODS: Our responses are based on the principles of social distancing, hand hygiene, respiratory etiquettes, surface disinfection protocol, and rational use of appropriate personal protective equipment (PPE). We describe our response in terms of administrative controls, clinical protocols, staff protection, environmental controls, and social distancing measures. We also discuss our communication strategies and monitoring systems, to ensure compliance to protocols. RESULTS: Administrative control is mainly related to formation of task force and its functions. Clinical protocols are related to patient triaging methods and clinical examination guidelines in Outpatient, Inpatient and Operating Room. Staff protection is focused on training staff on the protocols to be followed in hospital as well as at home, and use of PPE. Environmental protocol is focused on cleaning and disinfectant methods to be used in the hospital. In addition, there are systems for communication as well as monitoring compliance to protocols. CONCLUSION: We hope that these protocols and our experience would help the ophthalmic community globally and serve as a guide to protect ophthalmologists and ophthalmic care personnel, and their patients across the world.

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Re: Seah et al.: Assessing viral shedding and infectivity of tears in Coronavirus disease 2019 (COVID-19) patients (Ophthalmology. 2020;127:977-979)

Cited by 5 publications

References 4 publications

Ocular manifestations in COVID-19 infections: a case series

Ocular manifestations in COVID-19 infections: a case series

Efficacy of Slit Lamp Breath Shields

Response of L V Prasad Eye Institute to COVID-19 outbreak in India: experience at its tertiary eye care centre and adoption to its Eye Health Pyramid

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