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Warning to Australian eyecare professionals over coronavirus outbreak

Australian ophthalmologists have been warned that patients presenting with conjunctivitis could be infected with the deadly coronavirus, as the sector’s peak bodies urge eyecare professionals to be wary of people who have travelled from China.

Following the global outbreak of the disease which has infected more than 17,000 people and killed 361, RANZCO and Optometry Australia (OA) have taken proactive steps to ensure members avoid coming into contact with the virus, also known as 2019-nCOV.

RANZCO CEO Dr David Andrews confirmed the college had emailed fellows, trainees and associates an alert by the American Academy of Ophthalmology (AAO). It referred to anecdotal reports suggesting the virus can cause conjunctivitis and possibly be transmitted by aerosol contact with conjunctiva.

“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,” the AAO said.

“Therefore, protecting your mouth, nose (e.g. an N-95 mask) or eyes (e.g., goggles or shield) is recommended for health care providers caring for patients potentially infected with 2019-nCoV.”

Australia’s first coronavirus diagnosis occurred on 25 January and there are now 12 confirmed cases – four in New South Wales, four in Victoria, two in Queensland, and two in South Australia.

Ophthalmic practices have told Insight they have displayed notices to ask for symptoms to be discussed and use of masks if required.

On Friday, OA posted advice to its website urging members to take proactive steps by routinely asking all patients before their appointment – and again on arrival at the practice – if they have returned from China in the past two weeks.

“Based on advice from health authorities in Australia and overseas, Optometry Australia advises that the best risk averse option for optometrists and optometry practices is for optometrists to ask if a patient has returned from an affected area in China, or has returned from China with symptoms of fever, cough, sore throat or breathing difficulties,” the OA article stated.

“If they answer yes to either of these questions, it is safest not to see non-urgent patients until after the incubation period of two weeks has passed.”

Recommended practice

Health authorities have warned the virus appears to spread via respiratory droplets or if people touch an object with the virus and then touch their mouths, noses or eyes. Patients may be infectious before experiencing symptoms.

According to NSW Health advice, people are now at risk of catching the virus if they spend a quarter of an hour in close contact, such as a face-to-face conversation, or two hours in the same confined space with an infected person.

RANZCO (through the AAO) recommended steps to identify suspected coronavirus cases, including:

  • Does the patient present for conjunctivitis?
  • Does the patient also have respiratory symptoms?
  • Has the patient recently travelled internationally?
  • Does their international travel include a recent trip to China or with family members recently back from China?

If eyecare professionals do see a patient who has returned from China within the past two weeks or with the symptoms of a respiratory infection – even if they have not been to China recently – OA encouraged members to follow protocols recommended by The Centre for Disease Control in the US:

  • Where possible, provide patients with a surgical mask as soon as they are identified.
  • Conduct their evaluation in a private room with the door closed.
  • Provide a face mask for all personnel entering the room or dealing with the patient.
  • Implement basic infection control measures including hand hygiene, respiratory hygiene/cough etiquette (regular hand washing, covering mouth and nose when coughing and sneezing), and environmental disinfection.
  • Disinfect all surfaces they have come in contact with, including door handles and frames, equipment, chin rests, chair etc as per other virulent diseases (such as viral conjunctivitis).
  • 70% Isopropyl alcohol is the most effective disinfection agent. Alcohol wipes can be used to wipe down equipment etc.
  • Alcohol hand wash and wipes are usually available from pharmacies but may be out of stock. 99% isopropyl alcohol spray for disinfecting surfaces is available from Bunnings and Officeworks. 70% isopropyl alcohol wipes are also available from Officeworks.