Eyeworld Supplements

Headline ASCRS Copyright 2020 ASCRS Ophthalmic Corporation. All rights reserved. The views expressed in this publication do not necessarily reflect those of the staff and leadership of EyeWorld and ASCRS, and in no way imply endorsement by EyeWorld and ASCRS. difficult for some to return to work, especially those who might have childcare or other issues. It's important that we have routine communication with them. We made more than 1,000 cloth face masks, and these kinds of small mea- sures of goodwill carry a lot of weight. Keeping our staff and work family safe is of utmost importance because without them none of the clinic flow is going to happen. Do every- thing possible to distance pa- tients, make sure the balance of the patient volume coming in isn't too much, avoid traffic jams in the clinic, and make P ersonal protective equipment (PPE) is essential in re- turning to and maintaining a safe ophthalmic practice for staff and patients alike. In the Turning the Lights Back On: Part 1 session, Francis Mah, MD, described the most basic of PPE for COVID-19, a respiratory virus: the face mask. "Any face mask is better than no face mask," he said, discussing the different types of masks and face coverings that could be used, from cloth masks to surgical masks to N95 respirator masks. "The reason we're wearing face masks … is because it does reduce spread," Dr. Mah said, from both symptomatic and asymptomatic patients. Dr. Mah also explained that while wearing a face mask doesn't protect one from getting infected (unless it's a properly worn N95 respirator mask), it does reduce efficiency of viral spread. Patients should be encouraged to wear even a cloth face covering, if a surgical mask is not available, while doctors and staff should aim for having N95 masks and surgical masks. Other strategies Dr. Mah discussed to prevent COVID-19 spread included limiting exposure by creating a new check- in process, making adjustments to the waiting room (if patients are allowed to stop and wait there at all), resituat- ing staff work stations, and limiting talking within the exam room. Before sitting down at the slit lamp, Dr. Mah said doc- tors should tell patients they will not be talking during that portion of the exam and ask patients to refrain from talking during that close contact as well. Matthew McCarthy, MD, who also spoke during the session, was among the first COVID-19 attendings at his hospital in New York City. "I was on the ground floor figuring out best practices and figuring out how we were going to try to save people," he said. At the time of the 2020 ASCRS Virtual Annual Meeting in May, Dr. McCarthy said he doesn't wear an N95 mask. He wears a surgical mask, eye shield, and gloves. "The N95 mask is only recommended for aerosol generating procedures," he explained. "That being said, an ophthalmologist is going to be right in the patient's face for a long period of time, so it would not be unreasonable to wear an N95 mask and an eye shield." Unless you have point-of-care testing where you can re- ceive a result within 5 minutes of admitting patients to your clinic as to whether they have COVID-19, Dr. McCarthy said you should take universal precautions, assuming that every patient has it for the time being so that you are protecting yourself and your staff. Dr. McCarthy discussed the different types of testing available and the challenges with them. Antibody testing, for example, tells you if you've been exposed to the virus, not if you are immune. That should be kept in mind if con- sidering this as a factor for returning to work. For a vaccine, Dr. McCarthy said he's skeptical that one will be available by early 2021, as some have suggested. Most vaccines take years to develop, he said, noting the special challenges with creating vaccines for RNA viruses, like coronavirus. Editors' note: Dr. Mah is the director of the Cornea Service and co-director of the Refractive Surgery Service at Scripps Clinic, La Jolla, California. Dr. McCarthy is an assistant professor of medicine at Weill Cornell, New York, New York. sure they have the protection they need as well. Everyone on our staff has at least two cloth face masks. If you have direct contact with patients, you need the N95 face mask. To reiterate, it's important to query patients, making sure you're not letting anyone in who may be symptomatic or may have had exposure. Limit those coming in from hospitals or nursing homes. Editors' note: Dr. Yeu is an assistant professor at Eastern Virginia Medical School and practices at Virginia Eye Con- sultants, Norfolk, Virginia. PPE and other safety considerations Supported by Alcon

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