As we all know, coronavirus is a possibility for any of our patients, and conjunctivitis may be a presenting symptom. Therefore, the Tennessee Department of Healthand the AAO have the following recommendations for patients presenting with complaints of a “red eye":
1. Ask whether the patient also has respiratory tract symptoms.
2. Inquireif there is a history of recent international travel - particularly to Wuhan City or Hubei Province, China.
3. Identify if, within the last 14 days, he or she has had close contact with a confirmed coronavirus patient, one under investigation, or anyone recently back from China.
4. Offer a mask to ALL patients with red eye - particularly if they answered positively to any of the travel questions or have concurrent upper respiratory tract symptoms.
5. Both physicians and clinicalsupport staff should wear amask with an eye shield;there may be possible transmission by aerosol contact with the conjunctiva.
6. If there is any concern that a patient may have coronavirus, immediately call the TN State Health Department at 615–741- 7247. They will alert you on next steps.
Rebecca Taylor, MD
President, Tennessee Academy of Ophthalmology
Nashville Vision Associates
4306 Harding Rd, Suite 202
Nashville, TN 37205
(615) 297-6591 Office
(615) 915-5091 Fax
(615) 579-6828 Mobile
Member Alert
The Academy is sharing important ophthalmology-specific information related to the new coronavirus, referred to as "2019-nCoV," or simply the "Wuhan coronavirus." It is critical that all within our profession understand the risks associated with this outbreak to ensure our continued ability to care for our patients.
What you need to know
Anecdotal reports suggest the virus can cause conjunctivitis and possibly be transmitted by aerosol contact with conjunctiva.
Patients who present to ophthalmologists for conjunctivitis who also have respiratory symptoms and who have recently traveled internationally, and certainly those recently in China or with family members recently back from China, could represent cases of 2019-nCoV.
The Academy and federal officials recommend protection for themouth, noseandeyeswhen caring for patients potentially infected with 2019-nCoV.
Background
The 2019-nCoV virus causes severe respiratory infections, including pneumonia. Although the virus appears not quite as likely to cause fatalities as the SARS coronavirus or MERS coronavirus, a significant number of fatalities have already occurred.
There have been worldwide reports of infections, including several in the U.S. At the time of this message, U.S. health officials report five domestic cases and are testing patient samples from 26 states.
Patients present with respiratory illness, including fever, cough, shortness of breath and conjunctivitis. Severe complications include pneumonia. These can appear as soon as two days or as long as 14 days after exposure.
Among the newly published literature on coronavirus is apaper in the Lancetsuggesting patients may be infectious to others even before they experience symptoms of infection.
The virus appears to be spread via respiratory droplets. It also could be spread if people touch an object with the virus and then touch their mouths, noses or eyes.
U.S. Health and Human Services Secretary Alex Azar says that the reported cases are likely to skew to more severe infections and the mortality rate could drop over time. Federal officials are also trying to determine if there is asymptomatic transmission, which China has reported.
Ophthalmology ties
Because anecdotal reports suggest the virus can also cause conjunctivitis, it is possible that it is transmitted by aerosol contact with conjunctiva. While conjunctivitis is an uncommon event as it relates to 2019-nCoV, other forms of conjunctivitis are common. 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.
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.
Steps you should take
It is recommended that you evaluate your patients for the following factors to identify possible exposure to 2019-nCoV:
Does your patient present for conjunctivitis?
Does your patient also have respiratory symptoms?
Has your patient recently traveled internationally?
Does their international travel include a recent trip to China or with family members recently back from China?
The Centers for Disease Control and Prevention isurging health care providerswho encounter patients meeting these criteria toimmediatelynotify both infection control personnel at your health care facility and your local or state health department for further investigation of 2019-nCoV.
Email to a Friend_172090.png){kind=logo}