Courtesy of Dr. Taba, Personalized Retina Care of Naples
The American Academy of Ophthalmology has released recommendations regarding urgent and nonurgent patient care. According to the statement, all ophthalmologists should cease providing any treatment other than urgent or emergent care immediately. This includes both office-based care and surgical care. For example, intraocular injections for macular degeneration are considered urgent and therefore should be continued. If you are not sure of if your condition is urgent or not, call your eye doctor office.
The Academy is sharing important ophthalmology-specific information related to the novel coronavirus. referred to as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was previously known by the provisional name 2019-nCoV. This highly contagious virus can cause a severe respiratory disease known as COVID-19.
What you need to know
Several reports suggest the virus can cause conjunctivitis and possibly be transmitted by aerosol contact with conjunctiva. Patients who present to ophthalmologists for conjunctivitis who also have fever and respiratory symptoms including cough and shortness of breath.
The virus that causes COVID-19 is very likely susceptible to the same alcohol- and bleach-based disinfectants that ophthalmologists commonly use to disinfect ophthalmic instruments and office furniture. To prevent SARS-CoV-2 COVID-19 transmission, the same disinfection practices already used to prevent office-based spread of other viral pathogens are recommended before and after every patient encounter.
New Vaccine and treatment options
At this time, there is no vaccine to prevent infection, and no medication has been shown in a randomized clinical trial to be safe and effective. On March 5, mRNA coronavirus vaccine trials began enrollment at Kaiser Permanente Washington Health Research Institute in Seattle, one of 9 institutions in the Infectious Diseases Clinical Research Consortium, a clinical trials network supported by the National Institute of Allergy and Infectious Diseases (NIAID).
The American Academy of Ophthalmology has no opinion on the systemic safety or efficacy of chloroquine or hydroxychloroquine in mitigating COVID-19, though both are being investigated as prospective treatments. As always, the Academy urges that clinical decisions be guided by appropriate scientific evidence. However, the question has been raised as to whether the use of either medication requires a baseline fundus exam. No baseline ophthalmologic examination is needed in this situation, as the anticipated duration of treatment is short (up to 3 months). No ocular toxicity should be anticipated during this interval as long as dosages previously determined to be safe for the retina (generally <5mg/kg of real weight for hydroxychloroquine) are used.
Ophthalmology ties
Two reports suggest the virus can cause conjunctivitis. Thus, it is possible that SARS-CoV-2 is transmitted by aerosol contact with the conjunctiva.
In a Journal of Medical Virology study of 30 patients hospitalized for COVID-19 in China, 1 had conjunctivitis (“pink eye”). . That patient—and not the other 29—had SARS-CoV-2 in their ocular secretions. This suggests that SARS-CoV-2 The study suggested that COVID-19 can infect the conjunctiva and cause conjunctivitis, and virus particles are present in ocular secretions.
In a larger study published in the New England Journal of Medicine, researchers documented “conjunctival congestion” in 9 of 1,099 patients (0.8%) with laboratory-confirmed COVID-19 from 30 hospitals across China.
While it appears conjunctivitis is an uncommon event as it relates to COVID-19, it could still be a presentation of COVID-19. other forms of conjunctivitis are common. Affected patients frequently present to eye clinics or emergency departments. That increases the likelihood ophthalmologists may be the first providers to evaluate patients possibly infected with COVID-19.
At this time it is recommended to reschedule appointments for patients with nonurgent ophthalmic problems to reschedule their eye appointments.
If the office setup permits, patients who come to an appointment should will be asked prior to entering the waiting room about respiratory illness and whether they or a family member have traveled to a high-risk area in the past 14 days. If they answer yes to either question, they should be sent home and told to speak to their primary care physician. Most doctors are set up to offer you a telemedicine appointment at this time.
Practices will try to keep the waiting room as empty as possible and advise seated patients to remain at least 6 feet from one another. As much as prudent, reduce the visits of the most vulnerable patients will be reduced or the visit will be as short as possible.
If a patient with known COVID-19 infection needs urgent ophthalmic care, they should be sent to a hospital or center equipped to deal with COVID-19 and urgent eye conditions, ideally in a hospital setting under hospital infection control conditions.
Telemedicine services
The CMS and HHS have allowed for the expanded use of telehealth services during the COVID-19 public health crisis. According to the CMS, this option for services applies whether or not patients have COVID-19 symptoms. There are 3 options for telehealth and other communications-based technology services: telephone services, internet-based consultation or telemedicine exam. For complete and updated information, visit the Academy’s Coding for Phone Calls, Internet and Telehealth Consultations. Our office is capable of offering telemedicine services at this stressful time.
Ophthalmology ties
Because anecdotal reports suggest the virus can also cause conjunctivitis, it is possible that it is transmitted by aerosol contact with conjunctiva. While conjunctivitis is an uncommon event as it relates to 2019-nCoV, other forms of conjunctivitis are common. Affected patients frequently present to eye clinics or emergency departments. That increases the likelihood ophthalmologists may be the first providers to evaluate patients possibly infected with 2019-nCoV.
Patients should call and explain to the practitioner that they have their symptoms so they and the medical staff can take precautions as to not infect others via cross contamination.
Ask Yourself?
- Do I have an eye infection (conjunctivitis)?
- Do I also have respiratory symptoms?
- Has anyone I’ve been in contact with recently traveled internationally or been sick?
The Centers for Disease Control and Prevention is urging health care providers who encounter patients meeting these criteria to immediately notify both infection control personnel at your health care facility and your local or state health department for further investigation of 2019-nCoV. of COVID-19.
If you are experiencing any changes in your eye health, whether it is blurry vision, pain, impaired vision, or any other visual irregularities, it is imperative that you see an ophthalmologist right away. The earlier disease or disorders are detected, the better the outcome and treatment options are for you. Some eye diseases manifest only with blurry vision and can be painless: your vision might still be at risk. Only an eye professional can make the diagnosis and advise the proper treatment.
Personalized Retina Care of Naples provides incomparable diagnosis, medical and surgical treatment for retinal conditions and disorders. Dr. Taba is a Board-Certified Ophthalmologist and is Fellowship trained in surgical and medical retinal diseases.
To find out more, or to schedule your appointment, please call (239) 325-3970 today. We offer extended times to comply with social distancing.
Source: https://www.aao.org/headline/alert-important-coronavirus-context
Personalized Retina Care of Naples
www.retinanaples.com | 239-325-3970
3467 Pine Ridge Rd., Suite 103, Naples 34109