PMC:7272971 / 30485-33838 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7272971","sourcedb":"PMC","sourceid":"7272971","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7272971","text":"Clinical relevance\nThe conclusions from this review are clinically relevant both in terms of their implications for clinical practice, and in the wider education of patients. The nature of ocular examination demands that the eye‐care practitioner and patient are in close proximity to one another. Given the main mode of transmission of the virus is thought to be via person‐to‐person contact through respiratory droplets transmission (airborne or through direct contact), 80 it is unsurprising that ophthalmic practice has been significantly affected by the COVID‐19 pandemic.\nMany countries have temporarily stopped all routine appointments, moving to a service offering only emergency care during the height of the pandemic. Even with this precaution, in the case of a presumed ocular emergency, following initial remote consultation by phone or other electronic means, a face‐to‐face examination may still be deemed necessary. For these situations, eye‐care practitioners have been advised to take significant precautions to protect themselves and their patients from potential viral transmission. Five steps were recently summarised in relation to contact lens practice in particular,9, 81 including ensuring the patient is well, wearing personal protective equipment (PPE),81, 82, 83, 84, 85 installation of a protective shield on the slitlamp biomicroscope, 7 and thorough sanitisation of hands and all surfaces pre‐ and post‐visit. The precautions listed above are necessary to limit exposure of both the patient and eye‐care practitioner to the virus, and should remain in place until such time that the pandemic has been declared over or other measures can be implemented.\nThe conclusions shared in this review provide evidence and reassurance that the eye itself is unlikely to be a route for transmission, although this does not change the level of care required in clinical situations at present, given the potential to transmit the virus through airborne droplets and direct contact from the mouth and nose. One area that should be remembered, and already covered in this review, is that of the potential, albeit rare, for (kerato)conjunctivitis to present as the first sign of COVID‐19. All eye‐care practitioners must bear this in mind when triaging patients and considering how best to review, and potentially examine, or refer, a patient in this situation.\nGiven the need for contact lens wearers to touch their face and eyes on application and removal of their contact lenses, it is understandable that questions have been raised about the safety of continuing with contact lens use during the pandemic, as discussed in a recent paper by the present authors. 8 Despite the current review indicating that the eye is an unlikely site for SARS‐CoV‐2 infection, scrupulous contact lens hygiene practices should continue to be advocated, along with use of correct wear, care, cleaning and replacement of lenses and lens cases. This advice is true for all contact lens wearers in normal times, but especially relevant during the current pandemic, where access to routine eye care may be limited. Further, and in accordance with WHO and Centers for Disease Control recommendations,86, 87 it is important to remind all patients, regardless of their use of vision correction, to avoid touching their nose, mouth or eyes with unwashed 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