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Urgent and Emergent Eye Care Strategies to Protect Against COVID-19

Federal Practitioner. 2020 May;37(5)a:220-223
May 11, 2020|Federal Practitioner
Lisette Scheer, OD;Robert Hillsgrove, OD
Author and Disclosure Information

Lisette Scheer is an Optometrist and the Low Vision Director, and Robert Hillsgrove is an Optometrist; both at Viera VA Outpatient Clinic in Florida.
Correspondence: Lisette Scheer (lisette. scheer@va.gov)

 

Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.

Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner , Frontline Medical Communications Inc., the US Government, or any of its agencies.

Objective: This article presents additional strategies to the medical profession al and support tactics to keep both the health care provider and patient as safe as possible during the COVID-19 pandemic.

Observations: Follicular conjunctivitis has been reported as an early sign of infection or during hospitalization for severe COVID-19 disease. It has been confirmed that COVID-19 is transmitted through both respiratory droplets and direct contact. Another possible route of viral transmission is entry through aerosolized droplets into the tears, which then pass through the nasolacrimal ducts and into the respiratory tract. For nonemergent care, eye care providers should use telehealth. Eye care providers should prioritize patient care in order of absolute necessity, such as sudden vision loss, sudden onset flashes and floaters, and eye trauma. In those cases, exposure should be minimized. The close proximity between eye care providers and their patients during slit-lamp examination may require further precautions, such as shields, barriers, and mask use to lower the risk of transmission via droplets or through hand to eye contact.

Conclusions: All nonemergent eye care appointments should be delayed or conducted remotely. For emergent in-person appointments, careful and appropriate adherence to Centers for Disease Control and Prevention recommendations may minimize exposure for both the health care provider and patient.

Amid the COVID-19 pandemic, eye care professionals should be aware of important guidelines and consider using telehealth to keep both the health care provider and patient as safe as possible. This article is intended to give an update on the ever-changing landscape of eye care due to COVID-19. The Centers for Disease Control and Prevention (CDC) recommends that health care facilities and clinicians delay all elective ambulatory provider visits.1 In addition, the American Academy of Ophthalmology (AAO) recommends that all ophthalmologists cease providing any treatment other than urgent or emergent care.2 Our goal is to equip the eye care provider with the best practice guidelines for seeing urgent and emergent eye conditions.

COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and its symptoms range from mild to severe respiratory illness, fever, cough, fatigue, and shortness of breath.1 Diarrhea is common early on with infection and loss of taste and smell have also been reported.1 Follicular conjunctivitis has also been reported, either as an early sign of infection or during hospitalization for severe COVID-19 disease.2-4 The incubation period of COVID-19 falls within 2 to 14 days according to the CDC.5

It has been confirmed that COVID-19 is transmitted through both respiratory droplets and direct contact. Another possible route of viral transmission is entry through aerosolized droplets into the tears, which then pass through the nasolacrimal ducts and into the respiratory tract.6

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