Articles & publications

The following instructions are intended for the cleaning of the external surfaces of Topcon pretest equipment and the disinfection of the parts of the instrument that come in contact with the patient.

• KR-800PA, Auto Kerato-Refractometer with Color Mapping
• Aladdin HW 3.0, Biometer with Corneal Topography
• CA-200F, Corneal Analyser
• CA-800, Corneal Analyser
• CL-300 PDL, Computerized Lensmeter with PD measurement and LAN
• CL-300, Computerized Lensmeter
• CT-1/1P, Non-Contact Tonometer & Pachymeter
• CT-80, Non-Contact Computerized Tonometer
• CT-800, Non-Contact Computerized Tonometer
• CV-5000S, Computerized Vision Tester
• KR-1, Auto Kerato-Refractometer
• KR-1W, Aberrometer, Topographer, Keratometer, Pupillometer and Auto Refractometer
• KR-800, Kerato-Refractometer
• KR-800S, Auto Kerato-Refractometer with Subjective and Glare Testing
• LM-8/8E, Lensmeter
• RM-800, Auto Refractometer
• TRK-2P, Auto Kerato-Refracto Tonometer with Pachymeter

(…) Icare Finland Oy believes its Icare HOME Tonometer system is the solution ophthalmologists need in the coronavirus era. The device is small enough to fit in one’s hand, allows for 24-hour monitoring, and can be used at home as easily as in the clinic. It’s also based on a rebound measuring principle that requires no drops or specialized skills for its use, thus eliminating the risk of transmission via air particles. (…)

• Icare HOME, Handheld Contact Self-Monitoring Tonometer

RANZCO has cautioned that puff tonometry should not be used, and disposable probes are preferred when measuring the intraocular pressures of patients with, or suspected of having, glaucoma.

• Icare ic100, Handheld Contact Tonometer
• Icare ic200, Handheld Contact Tonometer
• Icare HOME, Handheld Contact Self-Monitoring Tonometer

Purpose

Coronavirus disease (COVID-19) has rapidly emerged as a global health threat. The purpose of this article is to share our local experience of stepping up infection control measures in ophthalmology to minimize COVID-19 infection of both healthcare workers and patients.

Methods

Infection control measures implemented in our ophthalmology clinic are discussed. The measures are based on detailed risk assessment by both local ophthalmologists and infection control experts.

Results

A three-level hierarchy of control measures was adopted. First, for administrative control, in order to lower patient attendance, text messages with an inquiry phone number were sent to patients to reschedule appointments or arrange drug refill. In order to minimize cross-infection of COVID-19, a triage system was set up to identify patients with fever, respiratory symptoms, acute conjunctivitis or recent travel to outbreak areas and to encourage these individuals to postpone their appointments for at least 14 days. Micro-aerosol generating procedures, such as non-contact tonometry and operations under general anesthesia were avoided. Nasal endoscopy was avoided as it may provoke sneezing and cause generation of droplets. All elective clinical services were suspended. Infection control training was provided to all clinical staff. Second, for environmental control, to reduce droplet transmission of COVID-19, installation of protective shields on slit lamps, frequent disinfection of equipment, and provision of eye protection to staff were implemented. All staff were advised to measure their own body temperatures before work and promptly report any symptoms of upper respiratory tract infection, vomiting or diarrhea. Third, universal masking, hand hygiene, and appropriate use of personal protective equipment (PPE) were promoted.

Conclusion

We hope our initial experience in stepping up infection control measures for COVID-19 infection in ophthalmology can help ophthalmologists globally to prepare for the potential community outbreak or pandemic. In order to minimize transmission of COVID-19, ophthalmologists should work closely with local infection control teams to implement infection control measures that are appropriate for their own clinical settings.

A whitepaper by Dr. Elizabeth Yeu of Virginia Eye Consultants, showing the agreement of the Aladdin biometer with the Lenstar biometer for routine measurements before cataract surgery.

• Aladdin HW 3.0, Biometer with Corneal Topography

A wide range of relatively cheap, wearable digital devices are now available that enable self-monitoring of parameters such as heart rate, blood pressure, physical activity and sleep patterns. Although these devices are often marketed at healthy people, new technologies that permit home monitoring may also have the potential to improve the detection and management of chronic diseases including glaucoma. If patients were able to measure their intraocular pressure or perform perimetry at home, many more measurements could be obtained, with the potential to improve our ability to differentiate true change from test–retest variability. Home monitoring may also improve our ability to determine efficacy of treatment and enhance patient engagement.

• Icare HOME, Handheld Contact Self-Monitoring Tonometer