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. 2020 May;258(5):1049-1055.
doi: 10.1007/s00417-020-04641-8. Epub 2020 Mar 3.

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

Tracy H T Lai  1   2 , Emily W H Tang  1   2 , Sandy K Y Chau  3 , Kitty S C Fung  4 , Kenneth K W Li  5   6
Affiliations

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

Tracy H T Lai et al. Graefes Arch Clin Exp Ophthalmol. 2020 May.

Abstract

Purpose: Coronavirus disease (COVID-19) has rapidly emerged as a global health threat. The purpose of this article is to share our local experience of stepping up infection control measures in ophthalmology to minimise COVID-19 infection of both healthcare workers and patients.

Methods: Infection control measures implemented in our ophthalmology clinic are discussed. The measures are based on detailed risk assessment by both local ophthalmologists and infection control experts.

Results: A three-level hierarchy of control measures was adopted. First, for administrative control, in order to lower patient attendance, text messages with an enquiry phone number were sent to patients to reschedule appointments or arrange drug refill. In order to minimise cross-infection of COVID-19, a triage system was set up to identify patients with fever, respiratory symptoms, acute conjunctivitis or recent travel to outbreak areas and to encourage these individuals to postpone their appointments for at least 14 days. Micro-aerosol generating procedures, such as non-contact tonometry and operations under general anaesthesia were avoided. Nasal endoscopy was avoided as it may provoke sneezing and cause generation of droplets. All elective clinical services were suspended. Infection control training was provided to all clinical staff. Second, for environmental control, to reduce droplet transmission of COVID-19, installation of protective shields on slit lamps, frequent disinfection of equipment, and provision of eye protection to staff were implemented. All staff were advised to measure their own body temperatures before work and promptly report any symptoms of upper respiratory tract infection, vomiting or diarrhoea. Third, universal masking, hand hygiene, and appropriate use of personal protective equipment (PPE) were promoted.

Conclusion: We hope our initial experience in stepping up infection control measures for COVID-19 infection in ophthalmology can help ophthalmologists globally to prepare for the potential community outbreak or pandemic. In order to minimise transmission of COVID-19, ophthalmologists should work closely with local infection control teams to implement infection control measures that are appropriate for their own clinical settings.

Keywords: COVID-19; Coronavirus; Hong Kong; Infection control; Ophthalmology; SARS-CoV-2.

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Conflict of interest statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Questionnaire on Fever, Travel, Occupation, Contact and Clustering (FTOCC)
Fig. 2
Fig. 2
Patient triage in the ophthalmology outpatient clinic. Abbreviations: A&E - Accident and Emergency Department; TOCC - Travel, Occupation, Contact and Clustering
Fig. 3
Fig. 3
Protective shield installed on a slit lamp
See this image and copyright information in PMC

Comment in

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