DOI: 10.1136/bjophthalmol-2020-315994 Kai Ching Peter Leung

Despite not urgent, many patients on the waiting list still got their ADL affected by the disease, they will suffer from delayed treatment.

Any body suffering from any infectious disease must not go for surgery including eye.

Lai THT, Tang EWH, Chau SKY, Fung KSC, Li KKW. Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: an experience from Hong Kong [published online ahead of print, 2020 Mar 3]. Graefes Arch Clin Exp Ophthalmol. 2020;10.1007/s00417-020-04641-8

I don't think Covid 19 affects the eyes, or at least there is no certainty

Conjunctivitis is one of the manifestation of COVID-19, and the mucosal surface of conjunctiva could be a way of transmission.

Reference:

https://www.aao.org/headline/alert-important-coronavirus-context

Some discussion mentioned in published studies as well:

CoVs are capable of producing a wide spectrum of ocular manifestations from anterior segment pathologies like conjunctivitis and anterior uveitis to sight-threatening conditions like retinitis and optic neuritis.

Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals, Ocular Immunology and Inflammation

Although eyes may not be affected, some ophthalmology practice day in day out is possible for generating microaerosol.

Britt JM, Clifton BC, Barnebey HS, Mills RP. Microaerosol Formation in Noncontact 'Air-Puff' Tonometry. Arch Ophthalmol. 1991;109(2):225–228

Does any ophthalmologist given up the usage of NCT under COVID-19?

Many microbes , such as Aspergillus fumigatus, Fusarium solani, Nocardia asteroides, Chlamydophila psittaci, Measles virus etc. are known to enter through eye causing conjunctivitis, keratitis etc. I have mentioned these infectious agents in my two books ,one entitled " Veterinary and Medical Mycology "published by Indian Council of Agricultural Research, New Delhi,India, and other entitled " Zoonoses" published by Satyam Publishers, Jaipur, India.

Whilst some opthalmic surgery can be done under local or regional anaesthesia, elective surgery increases the risk of transmission of Covid-19 to healthcare workers.

So please stop all elective surgery.

Elective surgery diverts resources from the front line of emergency management of Covid-19.

Anaesthetists are needed to manage critically ill patients.

Anaesthesia machines may be needed to ventilate patients.

AAO got some updates

https://www.aao.org/headline/list-of-urgent-emergent-ophthalmic-procedures

https://youtu.be/gAk7aX5hksU

It would be very useful to listen to this Korean Professor of infectious diseases at Korea University Guro Hospital.

Receptors of COVID 19 are in the mucosa of nose, mouth and in conjunctiva

https://blogs.bmj.com/bmj/2020/03/27/first-shift-on-the-covid-19-ward/

First shift on the covid-19 ward

March 27, 2020

• 797

A trainee ophthalmologist shares his experience of being redeployed to the frontline of covid-19 preparation and hopes that it will allay fears

This article may be of interest.

Some measures by the UK people

https://youtu.be/iIPTyzR0sg4

Telemedicine options: https://www.rcophth.ac.uk/wp-content/uploads/2020/03/Telemedicine-Options-for-Ophthalmology-Consultations-COVID19.pdf

Breath guards for slit lamps.

Stop face-to-face appointments for all non-urgent care. Convert to virtual consultations wherever possible.

More resources on RCOphth website: https://rcophth.ac.uk/2020/03/covid-19-update-and-resources-for-ophthalmologists/

DOI: 10.1001/jamaophthalmol.2020.1291

Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19)

Conjunctivitis can be the presenting sign of covid 19 before systemic manifestation.

Eye is one of the most important route for transmission other than nose and mouth.

Tears can transmit the infection.

No reported cases of intra ocular inflammation

Regards

.

Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol 2020. doi: 10.1002/jmv. 25725. Back to cited text no. 9

Assessing Viral Shedding and Infectivity of Tears in Coronavirus Disease 2019 (COVID-19) Patients

Ophthalmology

DOI: https://doi.org/10.1016/j.ophtha.2020.03.026

Shetty R, Ghosh A, Honavar SG, Khamar P, Sethu S. Therapeutic opportunities to manage COVID-19/SARS-CoV-2 infection: Present and future.

Indian J Ophthalmol [Epub ahead of print] [cited 2020 Apr 8].

http://www.ijo.in/preprintarticle.asp?id=281523

Assessing Viral Shedding and Infectivity of Tears in Coronavirus Disease 2019

(COVID-19) Patients

Ivan Seah Yu Jun, MBBS, Danielle E. Anderson, PhD, Adrian Eng Zheng Kang, BSc,

Lin-Fa Wang, PhD, Pooja Rao, MBBS, Barnaby Edward Young, MB, BChir, David

Chien Lye, MBBS, Rupesh Agrawal, MD

PII: S0161-6420(20)30311-0

DOI: https://doi.org/10.1016/j.ophtha.2020.03.026

In Saudi Arabia the lock down has resulted in depletion of medications. There is no warfarin available. Antimicrobials are in very short supply. Shipping charges have increased significantly. The situation is likely to be similar in other countries.

If medications are depleted mortality from non-Covid disease may be increased.

All non-essential medical activity must stop to preserve medications.

We must urgently determine which medications are effective for this condition to avoid wastage.

This lights up the research topic on non-COVID-19 related mortality under these few months, but will be difficult to accurately assess the extent. A very large scale collection of data would be needed

Reply to ocular manifestation, eye protection, and COVID-19.

Graefes Arch Clin Exp Ophthalmol (2020).

https://doi.org/10.1007/s00417-020-04663-2

Reply to “Does hand hygiene reduce SARS-CoV-2 transmission?”.

Graefes Arch Clin Exp Ophthalmol (2020).

https://doi.org/10.1007/s00417-020-04653-4

Will the corneal endothelium, retinal pigment endothelium be affected too?

Endothelial cell infection and endotheliitis in COVID-19

Lancet

https://doi.org/10.1016/S0140-6736(20)30937-5

A surge in eye clinic nonattendance under 2019 novel coronavirus outbreak. Indian J Ophthalmol  2020 Apr 21;68:948.

Available from: http://www.ijo.in/text.asp?2020/68/5/948/282891

https://doi.org/10.4103/ijo.IJO_673_20

Hi!

I recommend checking out our most recent publication on the management of neovascular AMD during the pandemic. We propose a new treatment regimen that can decrease the risk of COVID-19 cross-infection in clinic while preserving visual acuity improvements.

DOI: https://doi.org/10.1007/s00417-020-04693-w

Nice to read that, Fares!

A child confirmed COVID-19 with only symptoms of conjunctivitis and eyelid dermatitis.

Graefes Arch Clin Exp Ophthalmol (2020).

https://doi.org/10.1007/s00417-020-04708-6

How do blind people feel under COVID-19

http://www.crstonline.com/text.asp?2020/3/5/90/283316

Evaluation of ocular symptoms and tropism of SARS-CoV-2 in patients confirmed with COVID-19. Acta Ophthalmol. 2020 Apr 26.

Article Evaluation of ocular symptoms and tropism of SARS‐CoV‐2 in p...

Implications of COVID-19 for uveitis patients: perspectives from Hong Kong.

Eye (2020).

https://doi.org/10.1038/s41433-020-0905-1

Why ophthalmologists should mask: a perspective from Hong Kong. Eye (2020).

https://doi.org/10.1038/s41433-020-0916-y

https://pubmed.ncbi.nlm.nih.gov/32355114/

Improper Use of Germicidal Range Ultraviolet Lamp for Household Disinfection Leading to Phototoxicity in COVID-19 Suspects

@peter leung

The safe approach should be to wear a protective mask and paws because the disease has the ability to be transmitted through tears (for both the patient and the ophthalmologist) in treating conjunctivitis during the COVID-19 pandemic?

ACE2 and TMPRSS2 are expressed on the human ocular surface, suggesting susceptibility to SARS-CoV-2 infection.

Preprint ACE2 and TMPRSS2 are expressed on the human ocular surface, ...

Sunny, I found your paper on the controversies surrounding the wearing of face masks in ophthalmic practice in the current coronavirus situation enlightening and helpful.

Thanks Susan

I listend to lecture of reported case. Young medical staff presented with red eye with signs of viral conjuctivitis but less in severity than adnovirus conjunctivitis with no corneal involvement. They send him 3 times for pcr test and it was postive till one week after the eyes become normal. He has no any additional systemic symptoms. Take care please wn you deal with case of red eye. Regards for all

Hi everyone. Hope you are keeping safe. Our research team just published an article on combined phacovitrectomy (as opposed to sequential vitrectomy and cataract surgery) and its advantages during the pandemic and thereafter. We hope you find it useful. Here's a link: Article Vitreoretinal Surgery in the Post-Lockdown Era: Making the C...