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. 2003 Nov;87(11):1360-2.
doi: 10.1136/bjo.87.11.1360.

Minimising the risk of prion transmission by contact tonometry

S Z Amin  1 , L Smith, P J Luthert, M E Cheetham, R J Buckley
Affiliations

Minimising the risk of prion transmission by contact tonometry

S Z Amin et al. Br J Ophthalmol. 2003 Nov.

Abstract

Aims: The unknown prevalence of variant Creutzfeldt-Jakob disease (vCJD) in the UK population has led to fears of horizontal transmission through routine medical procedures. The potential risk of transmission via contact tonometry was examined.

Methods: The total amount of protein carried over by tonometer tips after applanation of patients was assessed.

Results: Tonometer tips had an inherent ability to carry proteinaceous material. There was a large variability in the load carried over between individual patients. Rinsing tonometer tips in water reduced protein carryover. Wiping the tonometer tips also reduced carriage, though less dramatically.

Conclusion: There is a small theoretical risk of transmission of vCJD by contact tonometry through reuse, but this should be reduced if the prisms are washed and wiped. In the light of these findings a protocol for the management of reusable tonometer prisms is recommended.

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Figures

Figure 1
Figure 1
Disposable tonometer heads mounted on reusable holders showing variations in the volume of the fluid meniscus. (A) shows the meniscus after shaking and (B) shows the meniscus without shaking.
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