• Comprehensive Ophthalmology

    The Academy is sharing important ophthalmology-specific information related to the new coronavirus, referred to as "2019-nCoV," or simply the "Wuhan coronavirus." It is critical that all within our profession understand the risks associated with this outbreak to ensure our continued ability to care for our patients.

    What you need to know

    • Anecdotal reports suggest the virus can cause conjunctivitis and possibly be transmitted by aerosol contact with conjunctiva.
    • Patients who present to ophthalmologists for conjunctivitis who also have respiratory symptoms and who have recently traveled internationally, and certainly those recently in China or with family members recently back from China, could represent cases of 2019-nCoV.
    • The Academy and federal officials recommend protection for the mouth, nose and eyes when caring for patients potentially infected with 2019-nCoV.

    Background

    The 2019-nCoV virus causes severe respiratory infections, including pneumonia. Although the virus appears not quite as likely to cause fatalities as the SARS coronavirus or MERS coronavirus, a significant number of fatalities have already occurred.

    There have been worldwide reports of infections, including several in the U.S. At the time of this message, U.S. health officials report five domestic cases and are testing patient samples from 26 states.

    Patients present with respiratory illness, including fever, cough, shortness of breath and conjunctivitis. Severe complications include pneumonia. These can appear as soon as two days or as long as 14 days after exposure.

    Among the newly published literature on coronavirus is a paper in The Lancet suggesting patients may be infectious to others even before they experience symptoms of infection.

    The virus appears to be spread via respiratory droplets. It also could be spread if people touch an object with the virus and then touch their mouths, noses or eyes.

    U.S. Health and Human Services Secretary Alex Azar says that the reported cases are likely to skew to more severe infections and the mortality rate could drop over time. Federal officials are also trying to determine if there is asymptomatic transmission, which China has reported.

    Ophthalmology ties

    Because anecdotal reports suggest the virus can also cause conjunctivitis, it is possible that it is transmitted by aerosol contact with conjunctiva. While conjunctivitis is an uncommon event as it relates to 2019-nCoV, other forms of conjunctivitis are common. Affected patients frequently present to eye clinics or emergency departments. That increases the likelihood ophthalmologists may be the first providers to evaluate patients possibly infected with 2019-nCoV.

    Therefore protecting your mouth, nose (e.g., an N-95 mask) or eyes (e.g., goggles or shield) is recommended for health care providers caring for patients potentially infected with 2019-nCoV.

    Steps you should take

    It is recommended that you evaluate your patients for the following factors to identify possible exposure to 2019-nCoV:

    • Does your patient present for conjunctivitis?
    • Does your patient also have respiratory symptoms?
    • Has your patient recently traveled internationally?
    • Does their international travel include a recent trip to China or with family members recently back from China?

    The Centers for Disease Control and Prevention is urging health care providers who encounter patients meeting these criteria to immediately notify both infection control personnel at your health care facility and your local or state health department for further investigation of 2019-nCoV.

    CDC 2019-nCoV Resources

     

    Photo Credit: Content Providers(s): National Institute of Allergy and Infectious Diseases (NIAID) - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #18109.