Standard precaution measurements during ophthalmology practice in the pandemic stage of COVID-19

Abstract

Aim: To take specific precautions and keep a safe practice during providing ophthalmology health services without compromising the patient's safety as well as the team workers and the community in the pandemic stage of corona virus disease 2019 (COVID-19).

Methods: Applying patient circulation scheme implemented in our ophthalmology centers with the guidance of ministry of health infection control guidelines started from the moment that we receive a call or WhatsApp message or Facebook inquiry from patients until 21d after patients first visit if any. Four directions were taken. First, community awareness of the disease and the ophthalmology related advices in how eye can transfers the infection and how to protect our eyes not to be infected through videos interviews of our consultants and distribution in social media like Instagram, Facebook, WhatsApp pages radio and TV interviews as well as leaflet health awareness for distribution for public. Second, scheduling of patients' appointments to prevent overcrowdings and cross infection. Third, protective measurements tools in the center to detect and prevent any exposure of the patients to patients and to protect medical staff, COVID-19 scoring 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 21d. Proper use of personal protective equipment was implemented. Stopping all the elective surgeries keeping only the emergency types advised by fourth: how to deal with our patients if they need an urgent ophthalmological intervention and how to deal with suspected cases of corona if any cases detected.

Results: Our measures helped our colleagues to try to keep providing ophthalmology health services without increasing the incidence of infection for COVID-19 until this pandemic is over.

Conclusion: In our practice, ophthalmologists should work with new aura of social media to facilitate the non-direct communication with the patients through maximizing the use of communication technology to keep contact with their patients and deal safely with COVID-19 cases.

Keywords: COVID-19; Facebook; Instagram; WhatsApp; corona virus; personal protective equipment.

Figure 1. Questionnaire form as per Omani MOH algorithm.

Figure 2. Waiting area

A, B: Posters of hand hygiene and personal contact are put on walls in all rooms. Care of cleaning in the center by cleaner is instructed to be regular every one hour by sodium hypochlorite 0.1%-0.5%; C, D: Safe distance marks are put in red color lines and spaces on the floor in front to reception desk, waiting areas and investigations rooms.

Figure 3. Medical staff informed to put surgical or N95 mask, gloves, head cover, eyes or face shield and to wear aprons.

Figure 4. Inside clinic precautions

A: Applanation tonometer can be used guided that cone is soaked with Cidex; B: Tonopen with disposable cover is used to measure IOP; C, D: Hard plastic slit lamp barrier that covers all the area between the doctor's face and patient's face to protect both of them from any infection that may come from that close contact.