Contact lens practice in the time of COVID-19
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Application, removal plungers or tools

If possible, patients should be instructed to bring their own application and removal (A/R) plungers. If a patient is unable to do so, the practitioner may choose to either sell or give patients a new set. For new patients without their own set of plungers, or when plungers must be provided by your office, disinfection is required after each use. If an autoclave is available, it can be used. If not, plungers can be soaked, fully submerged in 3% hydrogen peroxide for 3 hours. Rinse thoroughly with sterile saline and dry with a lint-free wipe.

Scleral lens protocols

Scleral lens patients should apply and remove their own lenses in a designated, disinfected workspace using their own A/R plungers, whenever possible. For new or inexperienced scleral lens patients, the practitioner may apply or remove the lenses but must wear a mask and gloves. When evaluating scleral lenses, you should limit the “settling time” as much as possible to reduce the patient’s time in your office. If more settling time is needed, the patient should wait outside the office, and you should have the examination room disinfected according to proper standards.

Training in applying, removing scleral lenses

The trainer should wear a mask, protective eye wear (including a face shield, if possible) and gloves. In lieu of gloves, hands should be washed with soap and water for at least 20 seconds prior to and after interacting with the patient. The patient should wear a mask or cloth face covering. If possible, a physical barrier between the patient and the trainer is recommended. New A/R plungers or tools must be used for each training session.

The entire work area, including solutions, mirrors, and table surfaces, should be disinfected after each training session. All patients should receive a new lens case and educational materials on COVID-19 infection control for scleral lenses. Scleral lens office staff should wear masks and gloves when handling diagnostic lenses. Scleral lenses should be shipped directly to the patient whenever possible.