You can also get some excellent information from Dr. Barry Eiden’s Research Review column below, which reports on a study of infection control measures in Hong Kong.
Although the current situation is tough for large and small businesses alike, it is important that we remain vigilant in our fight against COVID-19. We are sure that you and your offices have been affected in some way and would love to hear from you. Please share your experiences and lessons learned from this pandemic by sending us an email at email@example.com. In the Reader's Commentary section below, you can read about the experiences of one of our Italian colleagues, Daddi Fadel, DOptom.
Jason J. Nichols, OD, MPH, PhD
From Daddi Fadel, DOptom:
In Italy, the situation is dramatic, unfortunately. The hospitals are risking a collapse; the death toll is so high, as you said, it surpasses China. The reasons seem to be the average age of the population, which is greater than China (23.3% of its population is over age 65, compared to 12% in China). There is no room at cemeteries, and the crematorium is overwhelmed. [Bodies are being transported] to neighboring provinces just to give a dignified burial to these people who died in total solitude and without funerals.
Today, the Italians have been at home for 10 days. It is not easy to change the habits of Italians who love meeting with friends, going to restaurants, having happy hours and fun, and Sundays taking refuge with their parents. This is not easy also because, in Italy, the family and grandparents are the fulcrum of the Italian society that today is being put to the test. The elderly do not see their children and grandchildren, and they are also at higher risk of encountering the virus and having tragic consequences. These intergenerational interactions and co-residence may accelerate the outbreak in Italy. But while the family-oriented model may signify a risk of spreading infection, it may also represent a resource and a social shock absorber of the psychological and emotional stress and anxiety caused by the virus itself and by the forced isolation, which puts a strain on the human psyche. So, if every family member seriously and responsibly follows the recommendations provided by the World Health Organization, the Italian-family model becomes a resource and not a risk.
Failure to comply with recommendation is a characteristic of various peoples and not only of Italians. This is probably because the virus is an invisible enemy. This invisibility is what makes it so dangerous. By not seeing and not hearing it, people do not perceive the risk and the real threat. Instead, it is perceived as a disease that happens to others and not to me.
Currently, in Italy, we are in a very emotional state. On the one hand, we have the desire to continue meeting, and we do it on the balconies by singing and dancing, as if we want to ward off the virus and to continue to hope. On the other hand, there is silence, with everyone in an introspective state…because tomorrow this could happen to us.
Also, people are worried about their finances and about the national economic situation.
With little, we get excited. With little, we are moved. With little, we get irritated. With little, we have fun. But, our hope is immense. We all know that being united and complying with the recommendations is the only way to make it all right—and Italy will return the same as ever. We will do our best to make Italy great again, even greater.
I would also share what we have learned in Italy, it could be helpful:
- Don't waste time deciding to put yourself in quarantine. Your state did not declare it yet? Do it independently. The quicker we accept it and start the quarantine, the quicker this situation will end. Every minute may save lives.
- Sure, business is important, but now the priority is to contain the virus. So, let's think about one thing at a time.
- The only way to contain and to fight the virus is to STAY HOME!
- STAY HOME! Go out only once a week to the grocery.
- STAY HOME! Go out only for extremely important needs.
- Only ONE person per family should go out. This person should follow all of the precautions: mask, gloves, social distance, washing hands, etc.
- This may be hard to accept, but prepare yourself to STAY HOME for more than one month.
- Follow these basic instructions, and everything will be fine. The compliance of each person is literally vital, it may save lives and accelerate the end of the pandemic. Otherwise, the virus will continue to spread.
This is the only way to STOP the spread of the virus, to stay safe, and to take care of yourself and your beloved ones. This is very serious, and we need to be serious about it. DO NOT continue to underestimate coronavirus.
Quidel Receives Emergency Use Authorization for Molecular COVID-19 Diagnostic Assay
Quidel Corporation, a provider of rapid diagnostic testing solutions, cellular-based virology assays, and molecular diagnostic systems, announced that it has received Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA) to market its Lyra SARS-CoV-2 Assay, a real-time RT-PCR test intended for the qualitative detection of nucleic acid from SARS-CoV-2 in nasopharyngeal or oropharyngeal swab specimens from patients suspected of COVID-19 by their healthcare provider. Testing is limited to laboratories certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), 42 U.S.C. §263a, to perform high-complexity tests.
The Lyra product line offers PCR reagent kits for use by molecular diagnostic laboratories with existing molecular testing infrastructure such as the Applied Biosystems 7500 Fast DX instruments. The Lyra SARS-CoV-2 Assay is currently only available for sale in the United States and can be purchased either through Quidel’s salesforce or Cardinal Health.
ABB Optical Group Launches Patient Outreach and Virtual Trade Show Programs
ABB Optical Group announced two initiatives to assist eyecare professionals (ECPs) during this time of heightened health concerns regarding the coronavirus (COVID-19) situation. The company will be launching a free patient outreach program designed for eyecare practices to connect with patients and inform them of direct ECP-to-patient shipping options, a service provided by ABB Optical Group.
ECPs will be able to download a toolkit that contains social engagement posts, e-mail communications, and signage informing patients that they can place their contact lens orders through their ECP and receive their shipment at home—all without even coming into the office. ABB Optical Group customers will receive an e-mail with information about the patient outreach program and instructions on how to access the toolkit.
ABB Optical Group will also be hosting a Virtual Trade Show on March 23 to 27, in lieu of the recent cancelation of Vision Expo East in New York. The online event will feature free daily webinars hosted by subject matter experts and industry leaders. According to ABB Optical, the virtual shows will be focused on products, services, and solutions intended to help ECPs optimize their business and better serve their patients, both now and in the future.
NCC Announces New Dates
The Dutch Contact Lens Congress (NCC) has announced that the NCC2020-Beyond 2020 clinical conference has been rescheduled for Sept. 6 and 7, 2020. Additional information about the show is available at NCC2020.com.
Vision Source Postpones The Exchange 2020
Vision Source announced the postponement of The Exchange 2020, which was originally scheduled for April. At this time, a new date has not been set for the event. Additionally, the company will be hosting a Virtual Exchange this spring to ensure that its members and vendor partners have an opportunity to engage and take advantage of the exclusive Exchange offers for Vision Source members.
ABO and NCLE Provide Guidance During Coronavirus Pandemic
The American Board of Opticianry (ABO) and the National Contact Lens Examiners (NCLE) sent a notice to eyecare practitioners that detailed precautions that they should take as they work with patients during the coronavirus (COVID-19) pandemic. The National Academy of Opticianry has shared these guidelines with its members. The document notes that “based on guidance from the World Health Organization (WHO), the Center[s] For Disease Control [and Prevention] (CDC) and the American Academy of Ophthalmology (AAO), several reports suggest that the virus can cause conjunctivitis and possibly be transmitted by aerosol contact with conjunctiva. Patients who present for conjunctivitis who also have fever and respiratory symptoms including cough and shortness of breath could represent cases of COVID-19 even if they have not traveled internationally or been in contact with anyone that has traveled internationally. Although viral conjunctival infection is usually caused by adenovirus, COVID-19 may cause ocular signs and symptoms, including photophobia, irritation, conjunctival injection and watery discharge. These are predominantly self-limited but may require supportive care. Ocular discharge and tears are a potential source of contamination and the eye is also a route of exposure, so personal protection is required for the patient and the care team. Protection for the mouth, eyes and nose when caring for patients is recommended, whether they are potentially infected with coronavirus or not. The virus that causes COVID-19 is very likely susceptible to the same alcohol and bleach-based disinfectants that ophthalmic offices commonly use to disinfect ophthalmic instruments and office furniture.…It is important to proactively reinforce such infection mitigation techniques with doctors and staff, no matter the size of the office setting.”
Alcon Shifts to Virtual Operations
Alcon notified eyecare professionals that it is modifying the manner in which it engages with U.S. customers and shifting to a “full-time virtual approach” for its field sales force, effective immediately. The company’s transition to remote account management will remain in effect until further notice. Alcon also said that it has contingency plans to include alternative methods of product distribution and supplier sourcing, where possible. The company has also cancelled all training programs and practitioner meetings through the second quarter.
App Helps Prevent Exposure to Coronavirus in Medical Waiting Rooms
DocClocker, an app that enables patients to receive real-time wait time reporting of their medical providers, is helping to prevent the spread of COVID-19 (coronavirus) nationwide by enabling patients to avoid long waits in medical waiting rooms—limiting exposure risks, according to the company.
In addition to receiving real-time wait times, patients can easily locate and select in-network medical providers, selected by reviewing the provider’s specific information and a display of average wait times. Patients can manage appointments through the app, receive appointment reminders, write reviews, and report long waits. DocClocker is free to all patients and, according to the company, more affordable than other basic appointment management tools. The app is available for both Apple and Android.
Ortho-k Contact Lens Approved for Overnight Wear
Visionary Lens’ Mesa Grande (MG) reverse geometry specialty lens design was approved for overnight orthokeratology under the Bausch + Lomb U.S. Food and Drug Administration (FDA) pre-market approval for Vision Shaping Treatment.
CooperVision Accepting 2020 Science and Technology Award Submissions
CooperVision is now accepting submissions for its 2020 Science and Technology Awards program, with a focus on novel research concepts to address myopia and presbyopia. Over its history, the program has made 14 grants totaling $2 million to investigate matters such as ocular surface health, contact lens discomfort, contact lens functionality, and retinal response to optical defocus.
In 2020, submissions will be considered for the following subjects:
Strategies and interventions to slow myopia progression, with an emphasis on new technologies for treatment and management; effective solutions for fast progressors; understanding environmental factors that may initiate and prolong progression; and intelligent systems and data approaches for identifying at-risk eyes.
Technologies to enhance the optical functionality of contact lenses for the correction of presbyopia.
Proposals may span proof-of-concept through translational stages and are eligible for two types of awards. The CooperVision Seedling Award is intended for investigation of early stage concepts for a one-year period, with a maximum grant of $100,000. The CooperVision Translational Research Award is a two-year grant for substantive projects with funding up to $400,000. It is intended to incentivize collaboration with CooperVision in new research areas.
CooperVision Science and Technology Awards are open to any researcher with principal investigator (PI) status holding an OD, MD, PhD, or equivalent degree. Applicants such as postdoctoral fellows with a waiver of PI status must submit appropriate documentation before funding can be disbursed.
GP Lens Institute Announces 501(c)(3) Status, Board Expansion
The GP Lens Institute (GPLI) was granted 501(c)(3) IRS status determination in late 2019 as a tax-exempt, charitable organization. The current board includes president and executive director – Edward S. Bennett, OD, MSEd, professor emeritus at The University of Missouri St. Louis College of Optometry; vice president – Josh Adams, Valley Contax, Inc; and secretary treasurer – Derrell James, X-Cel Specialty Contacts. Board members at large are Kurtis Brown, Menicon America, Inc.; Daren Nygren, Custom Craft Lens Service of Nevada, Inc.; Chris Pantle, DAC International, Inc.; and Jan Svochak, TruForm Optics, Inc.
In March, 2020, the GPLI Board of Directors was expanded to include Robert L. Davis, OD, EyeVis Eye and Vision Research Institute; and Sara Yost, BS, MBA, BostonSight.
Sight Sciences Announces $30 Million Financing
Sight Sciences announced the closing of a more than $30 million Series E Preferred Stock financing round led by D1 Capital Partners. Proceeds will be used for continued clinical and operational development and to support commercial expansion for Sight Sciences’ OMNI and TearCare products.
Do you have an article that should be in Contact Lens Spectrum? Check out the submission guidelines here and send it our way!
Adolfos Kannetis, Limassol, Cyprus
This image shows a cornea with keratoconus. Best-corrected vision with spectacles was 6/24. The patient was fitted with a “humble” GP lens and had a visual acuity of 6/5. For more than 50 years, I have been fitting many different types of contact lenses (GP, soft, hybrid). And, before going to complicated fittings, I personally do not forget the “humble GP.”
We thank Adolfos Kannetis for this image and welcome photo submissions from our other readers! It is easy to submit a photo for consideration for publishing in Contact Lenses Today. Simply visit http://www.cltoday.com/upload/upload.aspx to upload your image. Please include a detailed explanation of the photo and your full name, degree or title, and city/state/country.
S. Barry Eiden, OD
Infection Control Measures in Ophthalmic Practice for COVID-19, the Hong Kong Experience
Coronavirus disease (COVID-19) has rapidly emerged as a global health threat. The purpose of a recently published article is to share the local experience of stepping up infection control measures in ophthalmology to minimize COVID-19 infection of both healthcare workers and patients.1
Infection control measures implemented in the authors’ ophthalmology clinic are presented. The measures are based on detailed risk assessment by both local ophthalmologists and infection control experts. A three-level hierarchy of control measures was adopted.
First, for administrative control, to lower patient attendance, text messages with an enquiry phone number were sent to patients to reschedule appointments or to arrange drug refill. To minimize cross-infection of COVID-19, a triage system was set up to identify patients who had fever, respiratory symptoms, acute conjunctivitis, or recent travel to outbreak areas. Additionally, patients in these at-risk categories were encouraged 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. 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 to 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.
The authors expressed hope that their initial experience in stepping up infection control measures for COVID-19 infection in ophthalmic practice can help eyecare practitioners (ECPs) globally to prepare for the potential community outbreak or pandemic. To minimize transmission of COVID-19, ECPs should work closely with local infection control teams to implement infection control measures that are appropriate for their own clinical settings.
Surely, our practice has stepped up its infection control measures, and we continue to adapt to the ever-changing landscape. So far, so good; however, that can change at any time. Perhaps in the long run, this experience is a wake-up call to all of us to pay closer attention to infection control in general. Let’s make something positive out of this challenging experience.
1. Lai THT, Tang EWH, Chau SKY, Fung KSC, Li KKW. Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: an experience from Hong Kong. Graefes Arch Clin Exp Ophthalmol. 2020 Mar 3. [Pub ahead of print]
OCULAR SURFACE UPDATE
Katherine Mastrota, MS, OD
The Story May Be in the Eyelashes
The number, texture, direction, color, and curvature of the eyelashes can offer clues to diagnosis/treatment of ocular surface symptoms/disorders. Alterations in eyelash growth and/or appearance can herald/precipitate/be associated with a variety of conditions. Some eyelash knowledge:
Eyelashes develop from ectoderm between weeks 22 and 26 of gestation. Although the length varies from person to person, they do not grow beyond a certain length; they then fall out by themselves. An epilated lash takes about eight weeks to grow back. Eyelash hair is not affected by puberty. Eyelash follicles are 2.4mm deep in the upper lid and 1.4mm in the lower lid. There are more active lash follicles in the upper lid compared to the lower lid (41% versus 15%). The function of eyelashes is to protect the eyes from particulate matter. They are also highly innervated, making them sensitive (have been compared to cat’s whiskers) to touch and again help protect the eyes. The human lower eyelid has 75 to 80 lashes in three to four rows, whereas the upper eyelid has 90 to 160 lashes scattered on five to six rows. Each lash has a hair shaft that extends outside the skin, a root that is under the skin, and a bulb, which is the enlarged terminal portion. The inferior portion of the bulb is in direct contact with the dermal papilla, which brings key mesenchymal-epithelial interactions in follicle cycling. Unlike the scalp, which has epidermis, dermis, and hypodermis, eyelid skin is thinner, having only the epidermis and dermis. Lash follicles also do not have arrector pili muscles, which straighten hair in response to cold or intense emotions.1
Spend a few moments to mentally catalogue the normal architecture of eyelashes across patient demographics (taking into account age and ethnicity). Let breaches of the lash line in your patient spark further investigation into ocular surface and other disorders.
Evaluation of Coronavirus in Tears and Conjunctival Secretions of Patients with SARS‐CoV‐2 Infection
This study aimed to assess the presence of novel coronavirus in tears and conjunctival secretions of SARS–CoV‐2‐infected patients.
Methods: A prospective interventional case series study was performed, and 30 confirmed novel coronavirus pneumonia (NCP) patients were selected at the First Affiliated Hospital of Zhejiang University from 26 January 2020 to 9 February 2020. At an interval of 2 to 3 days, tear and conjunctival secretions were collected twice with disposable sampling swabs for reverse‐transcription polymerase chain reaction (RT‐PCR) assay.
Results: Twenty‐one common‐type and nine severe‐type NCP patients were enrolled. Two samples of tear and conjunctival secretions were obtained from the only one patient with conjunctivitis yielded positive RT‐PCR results. Fifty‐eight samples from other patents were all negative.
Conclusion: We speculate that SARS‐CoV‐2 may be detected in the tears and conjunctival secretions in NCP patients with conjunctivitis.
Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS‐CoV‐2 infection. 2020 Feb 26. Available at https://onlinelibrary.wiley.com/doi/pdf/10.1002/jmv.25725. Accessed Mar. 20, 2020.