New Coronavirus Guidelines Updated For Ophthalmologists

    “Make sure physicians and staff wear gloves before touching any patients with conjunctivitis.”

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    Recently, there have been reports that some patients with coronavirus, aka COVID-19, have symptoms of conjunctivitis, which is also called pinkeye.

    Keeping this in mind, the American Academy of Ophthalmology (AAO) has issued new guidelines to ophthalmologists, which are aimed at limiting transmission of the extremely contagious virus SARS-CoV-2.

    The guidelines, updated and posted online on March 6, highlight key steps to clinicians about protecting themselves against the infection while providing medical care to already infected patients. The recommendations also highlight how to minimize the spread of the virus in the doctor’s office.

    So far, globally, COVID-19 has affected more than 102,200 and killed over 3,490 people. The United States officials have reported 335 confirmed cases of the coronavirus, with 17 deaths, so far.

    Two studies have suggested that the coronavirus may cause conjunctivitis.

    The first study reported that at least 1 in 30 patients, who were hospitalized with COVID-19 in China, have reported conjunctivitis. The study was published online last month in the Journal of Medical Virology.

    The second study, published online last month in the New England Journal of Medicine, found that 9 of 1099 patients reported having “conjunctival congestion” in China.

    Conjunctivitis caused by COVID-19 is quite uncommon; however, the AAO reminds ophthalmologists that other forms of conjunctivitis are common.

    Patients who have conjunctivitis often go to eye clinics or ERs and ophthalmologists are the first to clinically examine patients who could have been infected by the virus. So, they must take extra care to protect themselves from getting infected.

    AAO spokesperson Dr. Sonal Tuli said it is imperative to screen patients who may be infected with the virus.

    “We also have signs near check-in and at the front door to ask patients to let us know if they are experiencing any of the symptoms of COVID-19,” Dr. Tuli said.

    “Our clinic has identified an area that we would use in case of a suspected patient, which is isolated away from common patient areas so that we can immediately take any suspected patients there while we evaluate them and plan how to take care of them,” Dr. Tuli added.

    She recommended that in addition to screening for any symptoms of respiratory infection, patients should be screened for any signs of conjunctivitis.

    Dr. Tuli noted that 1 to 3 percent of patients with COVID-19 have reported conjunctivitis so she advised ophthalmologists to use disposable tonometer tips while checking intraocular pressure. That’s because some patients who reported conjunctivitis has the virus in their tears.

    As far as COVID-19-related conjunctivitis treatment is concerned, Dr. Tuli advised using artificial tears.

    She recommended physicians to use personal protective equipment, such as “gown, gloves, protective mask, and goggles or some sort of good eye protection,” as aerosols from coughing or sneezing could infect any mucus membrane, including in the mouth, nose, and eyes.

    “Make sure physicians and staff wear gloves before touching any patients with conjunctivitis,” Dr. Tuli suggested. She also reminded doctors to advise patients with conjunctivitis to wash their hands after touching their eyes or nose.

    “After the patient leaves the clinic, it is important to clean any surfaces with dilute bleach,” said Dr. Tuli. “Make sure any employees or physicians that have respiratory illness do not come to work and the most important thing is to hand wash and not touch any of the mucus membranes.”