What can we do as ophthalmologists to prevent SARS Coronavirus in our patients and our caregivers?

The emergence of the SARS-CoV-2 or severe acute respiratory syndrome coronavirus 2 can cause a severe respiratory disease known as COVID-19. From unverified reports, it appears that Dr. Li Wenliang MD, an ophthalmologist in China was the one who initially alerted officials on this possible RNA virus as he was infected by an asymptomatic glaucoma patient. Since its worldwide spread, some panic has developed on how best to identify and prevent the transmission given the high rates of death (estimated to be 5-35X higher than influenza-A especially in higher age group populations and those with medical co-morbidities like diabetes and cardiovascular disease). 

As an increasing number of patients present to medical facilities, ophthalmologists will be called to evaluate these patients alongside the fact that as a profession, ophthalmologists see an proportionally higher volume of patients and thus are at risk of contracting this unless we take recommended universal precautions. Ophthalmologists can help identify potential patients in the clinic by doing the following:

1. When reminding patients about appointments, recommend those with active respiratory illnesses and non-urgent ophthalmic issues to reschedule. 

2. Ask about travel to high-risk areas on check-in and active respiratory disease.

3. Wear protective material when identifying potential patients with COVID-19 infections. They also should wear masks to prevent droplet transmission. 

4. Identify patients with conjunctivitis. Two reports have confirmed that conjunctival changes have occurred in patients with confirmed COVID 19 and those with SARS-CoV-2 positive serologies have ocular secretions with the RNA virus present. 

5. Practice primary prevention. Wash your hands often for at least 20 seconds with soap and water. Hand sanitizer is a less recommended option. Limit touching your mouth, nose, and eyes as those can be entry points for the RNA virus.

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