COVID-19: Preliminary Clinical Guidelines for Ophthalmology Practices
Medical Hypothesis, Discovery & Innovation in Ophthalmology,
Vol. 9 No. 2 (2020),
4 March 2020
The zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and its resultant human coronavirus disease (COVID-19) recently appeared as a global health threat that can cause severe respiratory infection and terminal respiratory distress. By the first week of April, more than 1.3 million people had been globally infected and more than 70,000 had lost their lives to this contagious virus. Clinical manifestations occur shortly after exposure, or a few days later. There is controversy regarding the transmission of the virus through the tear and conjunctiva; however, there are reports that the ocular surface might be a potential target for COVID-19. The ease of transmission of this virus at close proximity presents a risk to eyecare workers. Several recommendations have been issued by local and national organizations to address the issue of safe ophthalmic practice during the ongoing COVID-19 pandemic. These guidelines have numerous similarities; however, subtle differences exist. The purpose of this paper was to discuss measures, with a specific focus on standard precautions, to prevent further dissemination of COVID-19 at Eye Clinics. We have proposed procedures to triage suspected cases of COVID-19, considering emergency conditions.
Photo Courtesy of Majid Moshirfar, MD FACS.
How to Cite
Keng Jin L. Coronavirus kills Chinese whistleblower ophthalmologist: American Academy of Ophthalmology announcement; 2020 [cited 2020 16 March]. Available from: https://www.aao.org/headline/coronavirus-kills-chinese-whistleblower-ophthalmol.
Parrish RK, 2nd, Stewart MW, Duncan Powers SL. Ophthalmologists Are More Than Eye Doctors-In Memoriam Li Wenliang. Am J Ophthalmol. 2020. doi: 10.1016/j.ajo.2020.02.014 pmid: 32169251
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5 pmid: 31986264
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. doi: 10.1016/S0140-6736(20)30211-7 pmid: 32007143
Prompetchara E, Ketloy C, Palaga T. Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic. Asian Pac J Allergy Immunol. 2020;38(1):1-9. doi: 10.12932/AP-200220-0772 pmid: 32105090
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-3. doi: 10.1038/s41586-020-2012-7 pmid: 32015507
Li X, Zai J, Zhao Q, Nie Q, Li Y, Foley BT, et al. Evolutionary history, potential intermediate animal host, and cross-species analyses of SARS-CoV-2. J Med Virol. 2020. doi: 10.1002/jmv.25731 pmid: 32104911
Del Rio C, Malani PN. COVID-19-New Insights on a Rapidly Changing Epidemic. JAMA. 2020. doi: 10.1001/jama.2020.3072 pmid: 32108857
Word Health Organization. Coronavirus disease (COVID-2019) situation reports. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
Jeff C. Coronavirus job losses could total 47 million, unemployment rate may hit 32%, Fed estimates: CNBC; [cited 2020 MAR 30 ]. Available from: https://www.cnbc.com/2020/03/30/coronavirus-job-losses-could-total-47-million-unemployment-rate-of-32percent-fed-says.html.
Jilani TN, Jamil RT, Siddiqui AH. H1N1 Influenza (Swine Flu). StatPearls. Treasure Island (FL)2020.
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-4. doi: 10.1016/S0140-6736(20)30628-0 pmid: 32192578
Su S, Wong G, Shi W, Liu J, Lai ACK, Zhou J, et al. Epidemiology, Genetic Recombination, and Pathogenesis of Coronaviruses. Trends Microbiol. 2016;24(6):490-502. doi: 10.1016/j.tim.2016.03.003 pmid: 27012512
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. doi: 10.1016/S0140-6736(20)30566-3 pmid: 32171076
Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020. doi: 10.1038/s41569-020-0360-5 pmid: 32139904
Heidary F, Varnaseri M, Gharebaghi R. The Potential Use of Persian Herbal Medicines Against COVID-19 Through Angiotensin-Converting Enzyme 2. Arch Clin Infect Dis. 2020;In Press(In Press). doi: 10.5812/archcid.102838
Gharebaghi R, Heidary F, Moradi M, Parvizi M. Metronidazole; a Potential Novel Addition to the COVID-19 Treatment Regimen. Arch Acad Emerg Med. 2020; 8(1): e40. Published online 2020 Mar 30. PMCID: PMC7114714.
Centers for Disease Control and Prevention. Symptoms of Coronavirus Disease 2019 2020 [cited 2020 16 March]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html.
Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Ann Intern Med. 2020. doi: 10.7326/M20-0504 pmid: 32150748
Wu J, Liu J, Zhao X, Liu C, Wang W, Wang D, et al. Clinical Characteristics of Imported Cases of COVID-19 in Jiangsu Province: A Multicenter Descriptive Study. Clin Infect Dis. 2020. doi: 10.1093/cid/ciaa199 pmid: 32109279
Gane SB, Kelly C, Hopkins C. Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome? Rhinology. 2020. doi: 10.4193/Rhin20.114 pmid: 32240279
World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation report - 46 [cited 2020 March 12]. Available from: https://www.who.int/docs/default-source/coronaviruse/situationreports/ 20200306-sitrep-46-covid-19.pdf?sfvrsn=96b04adf_2.
Tang X, Du R, Wang R, Cao T, Guan L, Yang C, et al. Comparison of Hospitalized Patients with Acute Respiratory Distress Syndrome Caused by COVID-19 and H1N1. Chest. 2020. doi: 10.1016/j.chest.2020.03.032 pmid: 32224074
The L. COVID-19: protecting health-care workers. Lancet. 2020;395(10228):922. doi: 10.1016/S0140-6736(20)30644-9 pmid: 32199474
Gharebaghi R, Heidary F. COVID-19 and Iran: swimming with hands tied! Swiss Med Wkly. 2020;150:w20242. 10.4414/smw.2020.20242
Centers for Disease Control and Prevention. Public Health Recommendations for Community-Related Exposure [cited 2020 16 March]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html.
Loon SC, Teoh SC, Oon LL, Se-Thoe SY, Ling AE, Leo YS, et al. The severe acute respiratory syndrome coronavirus in tears. Br J Ophthalmol. 2004;88(7):861-3. doi: 10.1136/bjo.2003.035931 pmid: 15205225
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 pmid: 32100876
Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine. 2020. doi: 10.1101/2020.02.06.20020974
Jun ISY, Anderson DE, Kang AEZ, Wang L-F, Rao P, Young BE, et al. Assessing Viral Shedding and Infectivity of Tears in Coronavirus Disease 2019 (COVID-19) Patients. Ophthalmology. 2020.
Wu P, Duan F, Luo C, Liu Q, Qu X, Liang L, et al. Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19) in Hubei Province, China. JAMA Ophthalmol. 2020. doi: 10.1001/jamaophthalmol.2020.1291 pmid: 32232433
Seah I, Agrawal R. Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals. Ocul Immunol Inflamm. 2020:1-5. doi: 10.1080/09273948.2020.1738501 pmid: 32175797
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020. doi: 10.1001/jama.2020.2648 pmid: 32091533
Lu CW, Liu XF, Jia ZF. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet. 2020;395(10224):e39. doi: 10.1016/S0140-6736(20)30313-5 pmid: 32035510
International Council of Ophthalmology. ICO Global COVID-19 Resource Center [cited 2020 1 April]. Available from: http://www.icoph.org/news/news_detail/602/ICO-Global-COVID-19-Resource-Center.html.
American Academy of Ophthalmology. Important coronavirus updates for ophthalmologists [cited 2020 1 April ]. Available from: https://www.aao.org/headline/alert-important-coronavirus-context.
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. Graefes Arch Clin Exp Ophthalmol. 2020. doi: 10.1007/s00417-020-04641-8 pmid: 32124000
Reviglio VE, Osaba M, Reviglio V, ChiaradiaP, Kuo IC, O’Brien TP. COVID-19 and Ophthalmology: A New Chapter in an Old Story. Med Hypothesis Discov Innov Ophthalmol. 2020 Summer; 9(2): 71-73.
Azzolini C, Torreggiani A, Eandi C, Donati S, Oum MA, Vinciguerra R, et al. A teleconsultation network improves the efficacy of anti-VEGF therapy in retinal diseases. J Telemed Telecare. 2013;19(8):437-42. doi: 10.1177/1357633X13501760 pmid: 24162839
Fatehi F, Jahedi F, Tay-Kearney ML, Kanagasingam Y. Teleophthalmology for the elderly population: A review of the literature. Int J Med Inform. 2020;136:104089. doi: 10.1016/j.ijmedinf.2020.104089 pmid: 32044698
Repici A, Maselli R, Colombo M, Gabbiadini R, Spadaccini M, Anderloni A, et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc. 2020. doi: 10.1016/j.gie.2020.03.019 pmid: 32179106
American Academy of Orofacial Pain. Considerations for the management and triage of ocular oncology cases during the COVID-19 pandemic [cited 2020 1 April]. Available from: http://www.aaoop.org/wp-content/uploads/2020/03/AAOOP-COVID19-Oncology-Considerations-UPDATED.pdf.
Atkins N, Hodge W, Li B. A Systematic Review Regarding Tonometry and the Transmission of Infectious Diseases. J Clin Med Res. 2018;10(3):159-65. doi: 10.14740/jocmr3294w pmid: 29416571
Otter JA, Donskey C, Yezli S, Douthwaite S, Goldenberg SD, Weber DJ. Transmission of SARS and MERS coronaviruses and influenza virus in healthcare settings: the possible role of dry surface contamination. J Hosp Infect. 2016;92(3):235-50. doi: 10.1016/j.jhin.2015.08.027 pmid: 26597631
Wong J, Goh QY, Tan Z, Lie SA, Tay YC, Ng SY, et al. Preparing for a COVID-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore. Can J Anaesth. 2020. doi: 10.1007/s12630-020-01620-9 pmid: 32162212
- Abstract Viewed: 2554 times
- Full Text PDF Downloaded: 1867 times