View ASF Slide Show PPT

---

Epidemic Keratoconjunctivitis (EKC)

Epidemic keratoconjunctivitis (EKC) is a common and highly contagious acute infection of the eye caused by adenovirus. Typically symptoms manifest as pain, blurred vision, sensitivity to light, edema of the eye lid, and pseudomembrane (1). Complications and permanent damage may occur. There is no universally effective cure, vaccine, or treatment available; topical corticosteroids may provide relief (7). Topical antiviral therapy and povidone iodine eye lavage has shown potential benefit in decreasing the duration of symptoms. Research has reported that corticosteroid treatment may delay the shedding of the cells from the ocular surface by enhancing the adenovirus duplication, not allowing the adenovirus to expire on its own (7). EKC is extremely contagious and often results in cases of epidemics or “runs” in eye care clinics. There is available laboratory testing, as well as rapid in-office testing to identify EKC. Correctly testing and identify EKC is extremely crucial in order to prevent further breakouts. For the majority of nosocomial EKC cases, individuals often contract the virus through routine eye care examinations, by use of contaminated equipment such as tonometers (7,8). With an average incubation period lasting from 7-14 days, affected individuals often do not make the association of contracting the virus with their recent eye examination (6, 7). The virus is known to last on surfaces, such a slit lamps, for an average of 4-6 weeks (7,8,10,11). There is greater severity for the prognosis of EKC than previously thought. Research reveals lasting damage caused by EKC such as permanent corneal damage and the acute symptoms spanning the duration of years. The underplayed original prognosis of EKC requires an updated review and even a possible new approach to handling the virus.

 

 

Universal Precautions in Ophthalmology and Optometry Practices- New Guidelines for Improved SafeSight

Standard Precautions are required in the care of all patients at all times:

1. All staff and providers must wash their hands before and after each patient encounter.
2. Use disposable gloves for every patient

Equipment and Instruments

• Use disposable examination materials when possible
• Use disposable tonometer tips on red eye examinations
• Use non contact tonometer or disposable tips on all eye examinations
• Do not use contact tonometry unless apparatus has been dismantled from slit lamp, scrubbed and soaked in proper disinfectant, rinsed, and fully sterilized
• Disposable single use eye drops if available
  • If only multi-use eye drop vials are available, withdraw individual drops for each patient into a sterile small syringe for each patient use.
  • Do not directly apply drops from a multi use bottle into any patient’s eye
  •  Eye drop vial must not have contact with the patient
  • If the bottle does come in contact with the patient’s eye the bottle must be discarded immediately
• Typical 70% isopropyl alcohol is NOT an effective sanitizer. Use medical grade disinfectants such as Cavi-Wipes or Sani-Wipes
• Dispose of swabs and tissues used in the instillation of eye drops immediately

Patient Examination Area

• Separate sign-in and waiting area for potential infected patients and clean all objects that a patient comes in contact with
• Designate a specific “pink” room for patients with any eye infections.
• Clean and disinfect surfaces after the patient is discharged with medical grade disinfectants.

In Case of an Epidemic Keratoconjunctivitis and Other Infectious Patients

• Temporarily remove possibly infected staff member
• All EKC diagnosis should be reported to county health departments and state public health offices
• Any patient who has been exposed to EKC should be immediately notified and treatment should be discussed with an eye care provider

EKC Prevention and Guideline in Ophthalmic Care Settings

Standard Precautions

• All staff members must wash hands before and after each patient encounters
• Use disposable gloves for every patient
• Any single use item, such as eye drop vials, should be disposed of when possible

Patient Examination Area

• Separate sign-in and waiting are for possibly infected patients
• Designate specific examination rooms for patients with eye infections
• Clean surfaces after the patients are discharged with medical grade disinfectant
  • exam chair
  • chin rest
  • head rim
  • hand grips

Equipment and Instruments

• Use disposable examination materials when possible
• Use medical grade sanitizer opposed to typically used 70% isopropyl Alcohol
• Eye examination equipment must be cleaned with medical grade sanitizer
• All surgical instruments must be properly sterilized after each use
• Dispose of swabs and tissues used in the instillation of eye drops immediately
• Single-use medication vials should be used when possible
  • If multi-use eye drop vials are used, the vial must not have contact with the patient.
  • If the bottle does contact the patient’s eye it must be discarded immediately

In Case of an EKC outbreak

• Temporarily remove possibly infected staff members
• All EKC outbreaks must be reported to local and state public health authorities
• Any patient who has been exposed to EKC may be a candidate for consideration of early and preventative application of ocular Betadine drops. This use is controversial and further studies are required.

If you have further questions or to report a suspected outbreak of cases, resources are available through your county or state health departments.

---

 

---

DO’s

---

DON’TS

---

---

 

TONOMETRY PRODUCT VENDORS

---

---

Tonosafe™