The emergence of severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, can cause a severe respiratory disease known as COVID-19. From unverified reports, it appears that Dr. Li Wenliang, 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 transmission given the high rates of death, estimated to be 5 to 35 times higher than influenza A, especially in higher age group populations and those with medical comorbidities such as 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 a proportionally higher volume of patients and thus are at risk for 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 nonurgent 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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Disclosure: Singh reports he is a consultant to Zeiss, Novartis, Regeneron, Genentech and Alcon and receives grant support from Apellis and Graybug.