Daniel B. Azzam, Sanja G. Cypen & Jeremiah P. Tao
Purpose: The authors aim to characterize oculofacial plastic surgery-related online interest that may be useful in forecasting demand and in designing patient-directed online resources.
Methods: The authors queried Google Trends for over 100 oculofacial plastic surgery terms. The main outcome measure was the top 50 oculofacial plastic surgery-related search terms from 2004 to 2020. Secondary outcomes were trends, including seasonality, and search volume changes during the COVID-19 lockdown (March–May 2020) compared to 2018–2019. Terms were analyzed individually and in thematic categories; controlled against generic search terms to account for general internet traffic.
Results: Between 2004 and 2020, searches for oculofacial plastic surgery altogether increased, surpassing the rate of internet traffic growth. One thematic category – eyelid malpositions – decreased month-over-month. The top five terms were “face lift,” “Bell’s palsy,” “puffy eyes,” “dark circles under eyes,” and “chalazion.” Eyelid neoplasms searches peaked in summer (R2 = 0.880) whereas cosmetic (R2 = 0.862), symptoms (R 2 = 0.907), and surgeries (R 2 = 0.140) peaked in winter. Overall, oculofacial-related searches decreased during the COVID-19 lockdown, although thyroid eye disease interest increased compared to 2018 or 2019 (+68.6%; adj. p = .005). Oculofacial plastic surgery interest in 2020 was inversely correlated to “COVID-19” searches (r = −0.76, p < .001).
Conclusions: Oculofacial plastic surgery searches increased since 2004 at a pace greater than that ascribed to internet traffic growth. The most searched terms were “face lift,” “Bell’s palsy,” “puffy eyes,” “dark circles under eyes,” and “chalazion.” Almost all oculofacial-related searches decreased during the COVID-19 lockdown.
Yaguang Hu Tianyan Chen Miaomiao Liu Li Zhang Fang Wang Shuo Zhao Hui Liu Han Xia Yawen Wang Li Li
The current outbreak of COVID‐19 has spread rapidly all over the world. Respiratory droplets and contaction with infected patients are the two major transmission routes. However, the value of tear virus nucleic acid is still not clear. We dynamic detected the SARS‐CoV‐2 in eye sample of one COVID‐19 patient with obstruction of common lacrimal ducts.
Besides the routine examination, nasopharyngeal and eye swab were continuously measured by polymerase chain reaction assay and next‐generation sequencing (NGS). Gene detection was performed for drug use guidance, and flow cytometry was performed to analyse the lymphocyte subsets.
Nasopharyngeal swabs were positive for 22 days, but eye swabs were still continuously positive for 2 weeks after nasopharyngeal swabs turned negative. The low level of lymphocyte and the high level IL‐6 lasted for almost 4 weeks, then became near normal. Next‐generation sequencing (NGS) confirmed the existing of SARS‐CoV‐2, HSV1 and HHV6B virus nucleic acid. The gene detection for drug use guidance showed the genetic locus ABCB1 (3435T>C) rs1045642 belonged to type CC and it mean the efficiency of lopinavir–ritonavir would be significantly decreased. The flow cytometry of lymphocyte subsets showed PD‐1+ CD95+ cells was accounting for 94.8% in CD3+ CD8+ T subset and for 94.8% in CD3+ TCRγδ+ T subset.
As obstruction of common lacrimal duct, positively detection in one eye for 2 weeks more after nasopharyngeal swab became negative. More eye swabs should be collected from COVID‐19 patients, especially from those immunocompromised, those with eye symptoms and those had a history of ocular diseases.
Francesco M. Quaranta-Leoni , Dion Paridaens & David Verity
In March 2020, at the outset of the current pandemic, ESOPRS issued detailed advice on the appropriate procedures that practicing oculoplastic surgeons should consider to limit the transmission of COVID-19, with this information updated in April 2020. This paper highlights the threat to training opportunities for future generations of oculoplastic surgeons, adjustments in healthcare delivery, modifications of scientific activity, and the possible role of telemedicine in oculoplastics.
Sze Chuan Ong, Muhammad Azri Bin Razali, Lyana Shaffiee, Jun Xing Yap, Terrence Tay Yin Fei, Seng Chee Loon, Victor Koh
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted primarily via respiratory droplets, contact with contaminated surfaces, or free-floating aerosols. The American Academy of Ophthalmology recommends the use of surgical masks and commercially available slit-lamp shields (Breath Shields; Carl Zeiss AG, Oberkochen, Germany). However, a lack of evidence exists regarding the true efficacy of slit-lamp shields. We attempted to replicate the spread of infected aerosols and large droplets in the clinical setting of a slit-lamp examination to evaluate the efficacy of protective equipment in reducing the risk of viral transmission….. FULL TEXT
John Liu, Annie Y. Wang, Edsel B. Ing
To evaluate the efficacy of slit lamp breath shields to prevent droplet spray from a simulated sneeze.
Experimental study to test the effectiveness of personal protective equipment.
The nozzle of a spray gun was adjusted to angularly disperse a mist of colored dye that approximated a patient sneezing on a dimensionally accurate cardboard slit lamp model. The designs of 6 commercially available breath shields and 1 breath shield repurposed from a plastic container lid were tested. Each breath shield was sprayed in a standardized fashion 3 times, and the amount of overspray was compared to spray with no shield and quantified. The surface area that was sprayed was calculated using a commercially available software with color range function. The average percentage of overspray of each breath shield was computed in comparison to the control.
The breath shields ranged in surface area from 116 to 924 cm2, and the amount of overspray varied from 54% to virtually none. Larger breath shields offered better protection than smaller ones. Breath shields attached to the objective lens arm were better barriers than those of comparable size hung by the oculars. A repurposed plastic lid breath shield, 513 cm2, was slightly curved toward the examiner’s face and allowed only 2% overspray. The largest breath shield (924 cm2) hung near the oculars and prevented essentially all overspray.
The performance of different designs of breath shields was variable. Even high-functioning shields should be used in conjunction with personal protective equipment including masks, goggles, and gloves and handwashing. Ideally patients should also wear a face mask during all slit lamp examinations.
Paul D. Langer, Francesco P. Bernardini
The unexpected, catastrophic emergence of the novel coronavirus has forced medical specialties the world over to adapt quickly to a new medical reality, and ophthalmology has been no exception. In fact, each subspecialty within ophthalmology has made its own short-term adaptations during the epidemic so as to continue caring for patients while keeping transmission of the virus to a minimum.
As we write this perspective in mid-April 2020, the United States is at or near the peak of the crisis, whereas Italy is approximately 2 weeks past its peak. At this point in the outbreak, our field, oculofacial plastic and orbital surgery, has adjusted to the pandemic in the following ways, with some predicted long-term effects resulting from these changes.
Shiu Ting Mak & Hunter Kl Yuen
At present, all parts of the world are hit hard by COVID-19. The first confirmed case of COVID-19 in the territory of Hong Kong was announced on January 23, 2020. Since then, oculoplastic surgeons in Hong Kong have been taking every measure to protect all healthcare workers and patients from contracting the disease. This paper aims to share the experiences of and measures taken by local oculoplastic surgeons in combating COVID-19. Three main aspects are discussed, namely clinical, administrative, and training and educational. We hope our experiences would provide reference to fellow oculoplastic colleagues in other parts of the world in fighting this COVID-19 pandemic.
Roger E. Turbin , Peter J. Wawrzusin , Nicole M. Sakla , Christin M. Traba , Kristin G. Wong , Neena Mirani , Jean A. Eloy & Esther A. Nimchinsky
We review two cases of adolescents with orbital cellulitis, sinusitis and SARS- CoV-2 infection presenting to emergency departments within a 24 hour period. SARS-CoV-2 samples obtained within 24 hours were positive, supporting prior infection despite relatively limited early symptoms of COVID-19. Unusual clinical and radiographic characteristics included hemorrhagic abscess with blood of varying age in the first, intracranial epidural abscess in the second, radiographic signal consistent with hemorrhagic or thrombotic phenomena, retro-maxillary antral fat changes, and meningeal enhancement or extension in both cases. Radiographic findings thereby mimic fungal infection, although final cultures and ancillary investigation for allergic and invasive fungal disease have remained negative. These cases highlight two unusual orbital presentations of cellulitis occurring in the context of SARS-CoV-2 co-infection.
Elizabeth Yang, Viv Sathianathan, Rabia Bourkiza & Evelyn Mensah
That’s my opening line to everyone in the intensive care unit (ICU) at Northwick Park Hospital, London North West University Healthcare NHS Trust (LNWH).
I’m a 4th year ophthalmology registrar working in LNWH eye department at Central Middlesex Hospital. Here’s what I’ve learnt from being deployed to ICU during the Coronavirus pandemic.
Why would they ask you?…….FULL TEXT