Be sure that your practice is accessible by phone and/or email and someone is actively checking messages. Don’t forget social media too which is a channel many patients use to reach you. Consider grace periods for contact lens prescription expiration and home shipping as a way to provide convenience. Good phone triage of what constitutes an emergency is also an essential element of safe practice these days. Severity and timing remain the two most important factors in determining an emergency: Did it happen suddenly and is it severe?
Especially important is screening patients for constitutional signs and symptoms of COVID-19 including fever, dry or productive cough, fatigue, shortness of breath, myalgia (muscle aches/pain), dizziness, confusion, headache, sore throat, anorexia (lack of appetite), hemoptysis (airway bleeding), rhinorrhea (runny nose), chest pain, diarrhea, nausea and vomiting, anosmia (loss of sense of smell), presence of conjunctivitis, recent travel, and contact with sick individuals.
Patients should also be specifically asked about recent positive, negative, or pending COVID-19 test results obtained for themselves and close proximity contacts.
Personal protective equipment (PPE) is a significant component, but only one part of the system protects staff and other patients from cross-infection. All clinical staff, including screening personnel, should wear PPE in congruence with regional guidelines, availability, and appropriateness to the symptomatology of the patient being treated.
Leave doors open, clean out the waiting room of all reading materials, and space the chairs apart.
Staff who examine patients in very close proximity such as with a slit lamp, or who operate on, or otherwise instrument the eye, should use ocular protection, gloves, and the examiner should only touch the patients’ eyes using a disposable cotton-tip applicator. Patients at higher risk may also be outfitted with similar PPE to reduce spread of the virus through droplets or contact.
If telemedicine or phone-based consultation is not appropriate for a given scenario, in-person visits should be carried out at extended intervals to avoid patient overlap.
Practices should consider the implementation of screening personal and high-visibility signage outside the entrance of their facility to recapitulate the screening questions mentioned above, as well as take direct temperature measurements to screen for active fever. Exterior signage should also make patients aware of appropriate social distancing strategies, such as the maintenance of six feet spacing between persons. These additional screening steps may capture patients who were missed by phone screening or developed symptoms between the time of phone screening and presentation.
The clinical environment, including instruments such as occluders, prisms, trial frames, trial lenses, and goniolens should be disinfected properly based on the official recommendations.
Contact lenses are believed to carry the virus as well, so special care and handling of contact lenses is especially critical. Avoid handling contact lenses that have been in someone’s eye and safely dispose of all used lenses and solutions.
Website popups, social media posts, and signage:
For the safety of all and to help stop the spread of COVID-19, please tell us if you have, or recently had, a fever, cough, fatigue, shortness of breath, muscle aches or pain, dizziness, confusion, headache, sore throat, lack of appetite, airway bleeding, runny nose, chest pain, diarrhea, nausea and vomiting, loss of sense of smell, presence of conjunctivitis, recent travel, and/or contact with sick individuals. If you have difficulty breathing, pain or pressure in the chest, confusion or inability to arouse, or bluish lips or face seek immediate medical attention.
Please also tell us about recent COVID-19 test results obtained for yourself or close contacts.
While in the facility, please maintain a safe distance between you and others of at least six feet
See the latest updates from the AOA at https://www.aoa.org/coronavirus