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1.
Eur J Ophthalmol ; 32(4): 2445-2451, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1354692

ABSTRACT

OBJECTIVE: To assess the patterns of patient generated aerosol in the context of ophthalmic surgery and ophthalmic examinations. To inform medical teams regarding potential hazards and suggest mitigating measures. METHODS: Qualitatively, real-time time videography assessed exhalation patterns from simulated patients under different clinical scenarios using propylene glycol from an e-cigarette. Quantitatively, high-speed Schlieren imaging was performed to enable high resolution recordings analysable by MATLAB technical computing software. RESULTS: Without a face mask, the standard prior to COVID 19, vapour was observed exiting through the opening in the drape over the surgical field. The amount of vapour increased when a surgical mask was worn. With a taped face mask, the amount of vapour decreased and with inclusion of a continuous suction device, the least amount of vapour was seen. These results were equivocal when the patient was supine or sitting upright. High-speed Schlieren imaging corroborated these findings and in addition showed substantial increase in airflow egress during coughing and with ill-fitting face masks. CONCLUSION: Advising patients to wear a surgical mask at the time of ophthalmic interventions potentially contaminants the ocular field with patient generated aerosol risking endophthalmitis. Surgeon safety can be maintained with personal protective equipment to mitigate the increased egress of vapour from the surgical drape and taping, with or without suction is advisable, whilst meticulous hygiene around lenses is required at the time of slit lamp examination.


Subject(s)
COVID-19 , Electronic Nicotine Delivery Systems , Endophthalmitis , Aerosols , COVID-19/prevention & control , Endophthalmitis/surgery , Humans , Personal Protective Equipment
2.
Br J Cancer ; 124(8): 1357-1360, 2021 04.
Article in English | MEDLINE | ID: covidwho-1072146

ABSTRACT

The COVID-19 pandemic has had an unprecedented impact on the National Health Service in United Kingdom. The UK Ocular Oncology Services evaluated the impact on the adult eye cancer care in the UK. All four adult Ocular Oncology centres participated in a multicentre retrospective review comparing uveal melanoma referral patterns and treatments in a 4-month period during the national lockdown and first wave of the COVID-19 pandemic in 2020 with corresponding periods in previous 2 years. During the national lockdown, referral numbers and confirmed uveal melanoma cases reduced considerably, equalling to ~120 fewer diagnosed uveal melanoma cases compared to previous 2 years. Contrary to the recent trend, increased caseloads of enucleation and stereotactic radiosurgery (p > 0.05), in comparison to fewer proton beam therapy (p < 0.05), were performed. In the 4-month period following lockdown, there was a surge in clinical activities with more advanced diseases (p < 0.05) presenting to the services. As the COVID-19 pandemic continues to mount pressure and reveal its hidden impact on the eye cancer care, it is imperative for the Ocular Oncology Services to plan recovery strategies and innovative ways of working.


Subject(s)
COVID-19/epidemiology , Eye Neoplasms/epidemiology , Melanoma/epidemiology , Pandemics , Uveal Neoplasms/epidemiology , COVID-19/complications , COVID-19/therapy , COVID-19/virology , Communicable Disease Control/methods , Eye Neoplasms/complications , Eye Neoplasms/therapy , Eye Neoplasms/virology , Humans , Melanoma/complications , Melanoma/therapy , Melanoma/virology , Proton Therapy/methods , SARS-CoV-2/pathogenicity , State Medicine , United Kingdom/epidemiology , Uveal Neoplasms/complications , Uveal Neoplasms/therapy , Uveal Neoplasms/virology
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