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    Comprehensive Ophthalmology

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    Review of: Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: an experience from Hong Kong

    Lai T, Tang E, Chau S, et al. Graefe's Archive for Clinical and Experimental Ophthalmology, in press

    Clinicians from Hong Kong share their recommendations for infection control measures in ophthalmology to minimize COVID-19 infection.

    Study design

    The authors discuss infection control measures they implemented at their ophthalmology clinic. The measures were based on detailed risk assessment by both local ophthalmologists and infection control experts.

    Outcomes

    Three levels of infection control measures were implemented

    • Administrative control: Patient attendance was lowered by postponing nonurgent appointments and suspending elective procedures. A triage system was implemented to identify patients with fever, respiratory symptoms and travel to hotspots and to encourage them to postpone their appointments. Noncontact tonometry and nasal endoscopy were halted due to potential aerosolization. In addition, all personnel underwent infection control training and monitoring
    • Environmental control: Improved air ventilation/HEPA filters were installed in waiting areas. In addition, large slit lamp protective shields, thorough disinfection of all surfaces between patients and video conferencing for meetings were implemented. Staff were asked to regularly monitor their temperatures and report any possible COVID-19 symptoms.
    • Use of personal protective equipment: Staff were equipped with eye protection (visors/goggles) and asked to pay careful attention to hand hygiene. Universal face masks were required for both ophthalmologist and patients. Ophthalmologists and staff examining higher risk patients with known/suspected COVID-19 wore full PPE [e.g., gown, gloves, cap, eye protection, mask (N95 when needed)].

    Limitations

    This is one hospital system's suggestions. There was no discussion of the effectiveness of these measures on reducing transmission.

    Clinical significance

    This study provides recommendations based on the authors’ initial experience in stepping up infection control measures during the COVID-19 outbreak. In order to minimize transmission of COVID-19, ophthalmologists should work closely with local infection control teams to implement control measures that are appropriate for their own clinical settings.