Contact lens wear and management of anterior eye disease in the time of COVID-19
As contact lens practitioners and as primary eyecare providers for people with anterior eye health complications, optometrists and ophthalmologists are at the forefront of managing these patients during the COVID-19 situation. As far as contact lens wear is concerned patients can continue to confidently wear their contact lenses without increased risk for contracting COVID-19. As for managing anterior eye conditions greater care with triage and unique ways of managing these patients will need to be adopted during this period.
Contact lens wear during the outbreak of the coronavirus causing COVID-19
There is no evidence to suggest that a contact lens wearer is at increased risk of contracting the virus causing COVID-19 Contact lens wearers should always practice good hygiene when handling lenses. It has been noted that contact lens wearers touch their face and eyes when inserting and removing lenses and when irritated by their lenses. Touching your face can spread germs and has been determined as a contributing factor in contracting COVID-19. Because of increased contact lens handling with new wearers we recommend new contact lens fittings wait until after the risk levels have reduced to Level 1 before taking up contact lens wear.
Exercise proper hand washing When using contact lenses or spectacles, one should wash their hands carefully and thoroughly with soap and water for at least 20 seconds, followed by hand drying with unused paper towels. This should occur before every contact lens insertion and removal. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. People should avoid touching their face, including their eyes, nose and mouth, with unwashed hands.
Disinfect contact lenses This critical step in contact lens wear is as important as ever. 2-weekly, monthly and longer-term hard of soft lenses should be cleaned daily following wear (and after hand-washing) with the prescribed contact lens cleaning system and stored in fresh solution. Old cases should be routinely exchanged or sterilized. If available for the prescription, disposable contact lenses would be the best advice to minimise the risk of any contact lens related infection.
Discontinue lens wear if sick Consistent with the standard rule-of-thumb, if you are sick or unwell with any cold or flu type symptoms, contact lens wear is not advised. The same applies if you contract COVID-19. If unwell remove you contact lenses and if confirmed you do have COVID-19 safely dispose of your contact lenses, the case and any solutions that may have come into contact with the virus - treat these items as contaminated.
Due to the complex nature of keratoconus or other corneal conditions that require a specific contact lens without the availability of suitable glasses, these unwell patients should speak to their optometrist, remotely in the first instance, as to the best management of their ocular condition during these times.
Contactless supply of contact lenses This can be readily achieved when working with our contact lens supply partners and should be undertaken in the first instance. Optometrists are urged to consider leniency with expired prescriptions and with patients that are overdue for routine contact lens follow-ups. Consider a remote consultation with these patients.
Glasses are not proven to offer protection There is no scientific evidence that wearing spectacles or glasses provides protection against COVID-19 or other viral transmissions. PLEASE CONTINUE TO PRACTICE PHYSICAL DISTANCING FROM THOSE OUTSIDE YOUR BUBBLE.
STAY AT HOME MESSAGE: Healthy individuals can continue to wear and care for their contact as they should be doing anyway!
Acute eye problems during the outbreak of the coronavirus causing COVID-19
Under Alert Levels 4 & 3 sight and life threatening ocular conditions are able to be seen following the necessary remote consultation triage and contact tracing protocols. If anyone has the symptoms of COVID-19 or at are risk they will need to be seen by an appropriate DHB facility.
Under Alert Level 2 low risk patients with routine concerns will be able to be seen. Contact tracing and infection control measures will still be in place.
We recommend keeping up to date with the Ministry of Health website and NZAO updates relating to what is and isn’t considered essential care under the different Alert Levels.
https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus
In the meantime you will need to ensure the following procedures are available to keep your patients, colleagues and yourself safe throughout the COVID-19 situation.
The ability to provide remote consultation to patients to avoid contact where possible or to minimise the time in close proximity to the patient; ie phone or video communications (in the members area we have a easy to use video option available for members)
COVID-19 risk management questionnaire
Contact tracing register
Personal protective equipment (gloves, masks, slit-lamp shield as a minimum)
Disinfection protocols
The CCLS wishes you all the best during this time of great challenge. Remember to reach out to your friends in the industry and enjoy the time with your bubble-mates.
Further reading:
https://core.uwaterloo.ca/COVID-19/