COVID-19 Updates for Ophthalmologists

In light of recent reports of conjunctivitis in patients with COVID-19, the American Academy of Ophthalmology (AAO) has issued updates aimed at limiting transmission of the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The updates were posted online March 6.
AAO highlights key steps physicians should take to screen patients for SARS-CoV-2, protect themselves against infection while caring for these patients, and minimize office-based spread of the virus.
To date, this novel virus has been associated with 93,090 cases of disease and 3198 deaths in at least 76 countries. In the United States alone, 129 confirmed and presumptive cases and nine deaths have been reported in 12 states.

Two recent studies now also suggest the virus may cause conjunctivitis.
In one of the studies, conjunctivitis was reported in 1 of 30 patients hospitalized for COVID-19 in China. This patient was also the only one who was found to have SARS-CoV-2 in their ocular secretions. The researchers report their findings in an article published online online February 26 in the Journal of Medical Virology.
In the second study, published online February 28 in the New England Journal of Medicine, “conjunctival congestion” was recorded in 9 of 1099 patients (0.8%) with laboratory-confirmed COVID-19 from 30 hospitals throughout China.
Although COVID-19-related conjunctivitis seems to be uncommon, the AAO reminds physicians that other forms of conjunctivitis are common. Patients with conjunctivitis frequently present to eye clinics or emergency departments, which increases the chance that ophthalmologists may be the first clinicians to examine patients who could have COVID-19.

Ophthalmologists and infectious disease physicians must therefore take measures to protect themselves and their other patients while caring for patients who are infected with SARS-CoV-2.
It is very important to screen patients who may be infected with SARS-CoV-2, Sonal Tuli, MD, spokesperson for the AAO and professor and chair in the Department of Ophthalmology, the University of Florida, Gainesville, told Medscape Medical News.
Persons who should be screened include those who have a history of recent travel to regions in which there are high rates of infection, as well as those who have symptoms suggestive of lower respiratory tract infection, such as shortness of breath, fever, and flu-like illness.
“We also have signs near check-in and at the front door to ask patients to let us know if they are experiencing any of the symptoms of COVID-19,” she said. These patients and their family members are immediately isolated, and a mask is placed on their face.
https://www.medscape.com/viewarticle/926365