Page 125 - July-August 2020

h. Space the appointments such performed. Disinfect contact be examined. The camera used
that there is no crowding, and points of lensometer after use to examine the patient needs
sufficient time is provided for g. While performing retinoscopy, to be disinfected using 70%
disinfection both the patient and optometrist isopropyl alcohol after every use.

i. All payment guidelines that have are required to wear face masks In case, there is a pathology that is
been incorporated for the optical h. Avoid contact of trial lenses suspected and fundus examination
shops will also apply to the to patient’s head and face. is not possible, it is recommended
optometry clinic. Disinfect trial frame after use to refer the patient to an
ophthalmologist.
PATIENT EXAMINATION with 70% isopropyl alcohol.
It is recommended to have CONTACT LENS GUIDELINES
Comprehensive eye examination 2 trial frames which can be
should be attempted to be interchanged and disinfected There is enough evidence to
completed within 20 min. Keep between use suggest that contact lenses are
the examination room door open i. Used trial lenses can either be safe to wear during COVID‑19
wherever possible to facilitate sanitized using 70% isopropyl times. The contact lens (CL) clinic
ventilation. If the room is air alcohol or soap and water. essentially should function as
conditioned, clean and disinfect Instances where cross cylinder is before with reinforcement of the
the filter at regular intervals. An used, avoid touching the patient care and maintenance instructions.
exhaust fan may be added on the forehead or face. If there is Hand washing with soap and
window behind the patient if there contact, disinfect cross cylinder water, CL hygiene including the
is a provision. work surface disinfection were
using 70% isopropyl alcohol and always a part of safe practices in
a. Wash hands in front of the wash hands with soap and water handling contact lenses. These
patient before examination with j. Phoropters are not are even more important in the
soap and water recommended as the lenses in COVID‑19 pandemic times. Few
b. History Taking: Wherever the phoropters will be in close additional steps like wearing
possible history to be elicited proximity to the patient and masks by both patient as well
through a phone call, which cannot be cleaned once exposed as the eye care practitioner and
avoids close proximity with k. Slit‑Lamp examination: Add a adding on larger breath shields
patient and also reduces the larger size breath shield on slit to slit‑lamp bio‑microscope to
time the patient spends in the lamps reduce droplets spread need
examination room to be incorporated. As of now,
l. Remove chin rest papers, so there is no evidence to prove that
c. Disposable gloves to be used that using disinfectant becomes contact lenses should not be worn
and disposed after examination easier. Head rest, chin rest, hand during COVID‑19 pandemic, or
of each patient holder, and other contact points that spectacles are preferable to

d. Autorefractometer, slit lamp, on slit lamp to be disinfected contact lenses. Patients should
phoropter, keratometer, after every use with 70% continue to wear lenses as advised
and topographer need to be isopropyl alcohol by their optometrist, maintaining
disinfected after every use m. Intra Ocular Pressure: Avoid good hygiene practice as has been
(forehead rest and chin rest, pneumotonometry. Applanation demonstrated in the clinic.
knobs) or TonoPen is recommended.
If the patient has an episode
e. Refraction: If patient has 20/20 of cold or flu like symptoms, they
or 6/6 vision with current DISINFECTION AND SANITIZATION need to discontinue wearing
spectacles, avoid retinoscopy OF INSTRUMENTS ARE LISTED lenses and resume only 24 h after
BELOW
f. For patients wearing spectacle, the symptoms resolve. The pair
prescription to be checked using n. Fundus Examination: in use should be discarded safely
lensometer. Disinfect spectacle Direct ophthalmoscopy should as medical waste. As of now daily
after removal from patient be avoided. However, if fundus disposable lenses do not offer any
face and before lensometry is camera is available, fundus can additional safety from COVID‑19

JULY-AUG 2020 | 121 COVID 19