Eye Hygiene and COVID-19 – What You Need To Know

Brief COVID-19 note:

Due to the timing of this blog (March, 2020) we would like to also remind readers that COVID-19 comes with many adverse health effects– including on the eyes. During this unprecedented time the AAO recommends discontinuing contact lens use in favor of wearing your back up glasses instead. While this is a good preventative measure ultimately social distancing is the best way to flatten the curve and reduce the spread of the illness. With that being said, one thing to consider is to order your at-home project supplies online and get them delivered right to your door.

Spring is upon us and that means it’s time for the dreaded spring cleaning, home improvements, and yard cleanup. At Kugler Vision, Omaha’s #1 LASIK provider, we want to ensure that as you are checking these tasks off your list you are using the proper eye safety equipment to do so. According to the American Academy of Ophthalmology (AAO), nearly half of all serious eye injuries occur at home.

As we mentioned, the most common eye injuries occur during tasks such as:

Cleaning – Bleach, often found in household cleaning products causes thousands of eye injuries each year. If you doget bleach in your eye, take it seriously.

Home Improvement Projects – Many home improvement projects entail sharp or heavy hand and power tools that, let’s be honest, most of us don’t use regularly. These devices can project and propel discarded material, screws, nails, metal shavings, wood chips, etc. capable of causing serious injury to the eyes and face.

Yard Work – Flying debris from lawn mowers, trimmers, weed eaters, shovels and other yard cleanup tools can be dangerous and lead to outdoor eye injuries.

If you experience an eye injury of any kind while at home it’s important to wash your hands, take out your contacts or remove your glasses, rinse the eye(s) with warm water and then proceed to the nearest medical facility to receive emergency care. Avoid rubbing your eyes or using eye drops until being looked at by a medical professional.

With these circumstances in mind, we’ve compiled a list of things you can do to keep your eyes safe as you prepare your home for the warmer weather. At the top of the list is to always wear protective eyewear. Studies show that taking this safety precaution could eliminate chances of an eye injury by up to 90 percent. Choosing which type of eyewear to use will depend on what you are doing.

It’s important to remember that your everyday contacts or glasses do not qualify as true eye protection. Regular eyeglasses or sunglasses are not certified by the American National Standards Institute (ANSI) for safety and can actually break or shatter if impacted which would result in additional eye injuries. When it comes to protective eyewear owning at least one ANSI approved pair is recommended. In most home project cases ANSI certified eyewear is more than enough.

There will be instances where accidents and injuries may occur in all areas of the home but taking the proper proactive safety measures could diminish the risk of them even more.

Consider these eye safety precautions while at home:

Read the labels of your cleaning solutions carefully to ensure you know the risks and safety measures to take in advance. It’s also important to know the first aid instructions if a situation occurs where your eyes are contaminated by these chemicals.

Before starting work on your lawn be sure to take a brief walk through to ensure there aren’t any loose twigs, rocks, or other debris that could be hazardous or become airborne if hit with a lawn mower or other yard tool.

Keep all tools and equipment in good condition and repair immediately if necessary. Using broken or damaged tools can result in an eye injury—one that could have been avoided.

When cleaning or spraying weeds outside be sure the nozzles are always facing away from you.

Another area that can be hazardous in the home is the kitchen. Hot appliances and sharp knives—these are just a couple of the the dangers located in the kitchen that could effect the eyes. In addition to the hot surfaces and sharp utensils there is also splattering grease, boiling water, and also foods that can burn and irritate the eyes if hands are not washed properly after handling them.

Eye hazards can be found all over the home but being proactive and setting an example for your children by using protective and certified eyewear is a great way to avoid eye injuries while at home.

Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Corona viruses and Ocular Implications in Humans and Animals

A Review ofCoronaviruses and Ocular Implications in Humans and Animals

In December 2019, a unique coronavirus epidemic, caused by the severe acute respiratory syndrome coronavirus – 2 (SARS-CoV-2) emerged from China. This virus causes the coronavirus disease 2019 (COVID-19). Since then, there are anecdotal reports of ocular infection. The ocular implications of human (CoV) infections haven't been widely studied. However, CoVs are known to cause various ocular infections in animals. Clinical entities like conjunctivitis, anterior uveitis, retinitis, and optic neuritis are documented in feline and murine models. This evidence suggesting possible human CoV infection of ocular tissue is surveyed. We hope that this may function a start for further research into the ocular implications of human CoV infections.

CoVs rose to public prominence after the outbreak of the Severe Acute Respiratory Syndrome.The SARS-CoV outbreak was reported to possess infected over 8000 people and resulted in 774 deaths globally. Since then, the Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) has also been within the public spotlight.

A set of recommendations for private protective equipment (PPE) supported the experience of MERS-CoV and SARS-CoV are released.7 This set of advice includes wearing goggles or faceshield for defense against ocular transmission of the CoV.

The Coronavirus Structure and Host:

The CoV name may be a derivative from the Latin word corona which suggests crown. this can be because of the characteristic structure of the virus whereby surface projections on the viral envelope provides it an appearance almost like a crown. The virus may be a single-stranded positive-sense RNA virus with a genome of around 30 kb long. This makes them the most important known RNA viruses. The S-protein is answerable for attachment to host receptors, M protein helps shape the virion particles and binding to nucleocapsid, E-protein plays a job within the assembly and release of particles while N-protein aids with the binding of the genome to a replication-transcription complex which is required for the replication of genomic material.

Human Coronaviruses and also the Evidence for OcularManifestations

There are seven types CoVs known to infect humans

·         Alpha coronavirus 229E

·         Alpha coronavirus NL63

·         Beta coronavirus OC43

·         Beta coronavirus HKU1

·         Beta coronavirus MERS-CoV

·         Beta coronavirus SARS-CoV

·         And Recent SARS-CoV-2(COVID-19)

Feline Coronaviruses and Ocular Manifestations:

The feline CoV (FCoV) is an Alphacoronavirus that affects both domestic and wild cats. Approximately 20–60% of domestic cats are seropositive, while in animal shelters, the seropositive rates can approach almost 90%. FCoVs is further classified into two biotypes which reflect very varied clinical presentations.

·         Feline enteric CoV (FECV)

·         Feline infectious peritonitis virus (FIPV)

In majority of those seropositive cases, the FCoVs exist as FECV. For many of the FECV cases, the infection is typically benign or related to a self-limiting diarrhea. This can be because FECV has been shown to demonstrate tropism to the apical epithelium of the intestinal villi from the tiny intestine to the cecum. As such, FECV shedding in feline feces is answerable for the fecal–oral spread and maintenance of FECV infection in feline populations, explaining the high seropositive rates of the infection.

The ocular manifestation of FIP is probably going because of underlying vasculitis, leading to inflammation of varying ocular segments. During a study that observed FIPV-infected felines and their offspring, 90% of the infected cats had FCoV antigen detected within the conjunctiva. Viral isolates from conjunctival swabs also contained live FCoV which suggest that ocular tissues and secretions were potentially infectious additionally. Furthermore, the initially healthy offspring, after being kept with the infected parents for 100 days, developed recurrent bouts of conjunctivitis. Except for conjunctivitis, ocular manifestations include pyogranulomatous anterioruveitis, choroiditis with detachment of the retina and retinal vasculitis. In general, ocular manifestations of FIPV infection have poor prognosis both visually and systemically.

 Conclusion:

As CoVs can cause ocular infection across different animals, the likelihood of SARS-CoV-2 having ocular implications can't be ignored. However, the examples in animals also highlight that CoVs are a heterogeneous group of viruses that may cause ocular implications through a good sort of mechanisms. A number of these mechanisms are extremely different from those adopted by human CoVs. Nevertheless, there are lessons to be learned by understanding these infections. Firstly, CoVs are capable of manufacturing a good spectrum of ocular manifestations from anterior segment pathologies like conjunctivitis and anterior uveitis to sight-threatening conditions like retinitis and optic neuritis. Secondly, it's going to even be prudent to acknowledge that CoVs also can develop in-vivo mutations which drastically alter the manifestations of the disease.

Given the anecdotal nature of evidence regarding SARS-CoV-2 transmission through ocular tissue, more research must be done to verify its ability to infect ocular tissue and its pathogenic mechanisms. Because the current epidemic continues, an improved understanding of the virus will emerge, hopefully with more emphasis on research into the connection between human CoVs and also the eye. This understanding won't only help to guide infection control measures but also can provide insights on the feasibility of using ocular tissue or perhaps tears as a medium of diagnosis. Meanwhile, ophthalmologists and other health-care workers should still err on the side of caution and still prevent the possible transmission of CoVs through ocular tissue.