7.4 Special Precautions
7.4.1 Disinfection of Ophthalmic Instruments
- Non-contact tonometer
- Disinfect with 70-75% ethanol or isopropyl alcohol immediately after each patient
Instruments that had direct contact with patient’s ocular surface
- Goldmann applanation tonometer prisms
- Diagnostic contact lenses
- Disinfect by immersion in either 1:10 diluted bleach solution with sodium hypochlorite or 3% hydrogen peroxide for at least 5 minutes.
Other surgical instruments
- Sterilized according to standard protocols.
7.4.2 Risk with Non-contact Tonometry (NCT)
- The air jet impacted on the tear film was reported to generate micro-aerosols.
- SARS-CoV-2 was reported to be present in tears and conjunctival secretions from COVID-19 confirmed patients with conjunctivitis
- Extra caution in patients with red eyes
- Operators should wear proper face mask or respirator
- Alternative methods to NCT: rebound tonometry
7.4.3 Ophthalmic Operations
- Surgical mask should be worn by all patients entering operating rooms
- Adhesive tape could be applied across the nose bridge area to ensure complete coverage of patient’s nose and mouth
- Require patients changing their clothes and putting on surgical caps
Suspected respiratory infection cases (urgent operations)
- Scheduled as last case of operation
- Thorough disinfection afterwards
- Be cautious and vigilant against sharp needles or blades injury
High risk or confirmed cases
- Refer to hospitals that have adequate facilities such as negative-pressure isolation rooms
Britt JM, Clifton BC, Barnebey HS & Mills RP (1991): Microaerosol Formation in Noncontact ‘Air-Puff’ Tonometry. Archives of Ophthalmology 109: 225-228.
李纯纯, 唐媛, 陈张艳, et al. 非接触式眼压计测量产生气溶胶密度变化及其对疫情防护的意义.中华实验眼科杂志. In press.