Many times when patients are coming for full eye examination, we have to come to close distance with the patients for pupillary examination, ocular motility, confrontation visual field, drop instillation and refraction. Is there any specific guideline to minimize the risk of Covid-19?
This link provides a detail guideline on optometric practices.
https://www.aoa.org/covid-19-guidance-for-optometric-practices
From the American Academy of Ophthalmology
https://www.aao.org/headline/alert-important-coronavirus-context
These two articles provide useful guidelines for ophthalmologists during the COVID-19 pandemic:
Article Facing COVID-19 in Ophthalmology department
Article Preliminary Clinical Guidelines for Ophthalmology Practices
THIS IS very good question. Although lots of articles, many are impractical.
Fogging, the refractive nature of the face shields , discomfort actually is causing people to actually frequently bring their hands to their faces.
Also, lots of people have come up with Do it yourself projects, although it look promising, we do not have enough evidence on how helpful or protective it is. as long as the manufacturing industries don't work together with front liners, this may never actually get resolved.
Everything that is produced, has to be tested for its efficacy and superiority before entering the red zone.
A sense of pseudo protection is more dangerous than no protection itself.
Honestly, many of eye hospitals in Nepal are not folllowing any proper guidelines against COVID-19. We are working with mere surgical mask; no gloves; no face shield; no PPE at all. We have been instructed to use surgical mask only. I don’t know wheter they have studied well that mere mask is enough to combat this pandemic or they are running out of budget to supply necessary PPE to all the staff.
I humbly request all the executive and management level to be serious in this issue and provide what we deserve to stay safe and make others safe.
As it is alleged that virus is excreted in tears so you have to use N95 mask and gloves ( for every patient). Or sanitize your hands and wash them after seeing every patient. Conjunctivitis can be early manifestation in Covid. These patients should be seen with all PPEs. Slit lamp has to have protective shield. Tonomet has to be cleaned after single use With chin rest. And we do not see any patient in clinic without Them wearing mask. also every patient has to answer few basic questions about any respiratory symptoms and travel history and any contact with Covid patient before admitting in Eye clinic.
Es imprescindible el uso de mascarilla por parte del paciente todo el tiempo, minimizar el acercamiento al paciente, si necesita valorar el fondo de ojo, es preferible solicitar una retinografia color.
La lampara de hendidura debe tener una pantalla que separe al paciente del medico.
En caso de requerir tocar al paciente durante el examen, utilizar guantes desechables.
El oftalmologo debe usar mascarilla, y gafas de protección todo el tiempo, realizar desinfección de los equipos con alcohol por cada paciente que se atienda. Utilizar traje que cubra completamente los brazos y cuello alto.
En el consultorio deben existir dispensadores con alcohol distribuidos estratégicamente tanto para el uso médico como para los pacientes.
Cualquier medida de protección es poca, en mi país, uno de los primeros médicos en morir por COVID fue un Oftalmólogo.