Ocular Manifestations of Ebola Virus Disease: An Ophthalmologist’s Guide to Prevent Infection and Panic

Table 2

Summary of the main recommendations for the treatment of suspected Ebola virus infected patients in ophthalmologic care settings (from CDC and WHO websites).

Personal Protective Equipment (PPE)	Ebola virus infection may be transmitted through broken skin and mucosae	Gown, gloves (possibly double gloves), surgical mask, eye visor/goggles, or face shield to protect conjunctival, nasal, and oral mucosae at the same time; Choose PPE of exact size; Gloves or other PPE that becomes contaminated by blood or bodily fluids must be cleaned or changed before touching other instruments or surfaces; Gloved/ungloved hand hygiene. Use alcohol-based hand rub or soap and running water	Strength of the evidence; High
Sharp instruments	Sharp instruments are extremely dangerous because they become contaminated by blood or bodily fluids and may break skin/mucosae even if protected by PPE	Use of needles and other sharp instruments must be limited. These instruments must be handled with extreme care and disposed after use in dedicated seal containers	Strength of the evidence; High
Droplets	Airborne transmission is not demonstrated; Preventive measures are recommended under the Precautionary Principle	If aerosol generating procedures or events, such as coughing or sputum induction, occur, the use of powered air-purifying respirator or respirator (FFP2 or EN certified equivalent or US NIOSH-certified N95) is recommended	Strength of the evidence; Low
Nonsharp instruments	Indirect transmission through nonsharp contaminated instruments is not demonstrated; Preventive measures are recommended under the Precautionary Principle	Use of disposable medical equipment is recommended or, alternatively, nondisposable medical equipment must be cleaned and disinfected after use according to manufacturer’s instructions	Strength of the evidence; Low
Environmental surfaces	Environmental surfaces do not pose a risk of infection. However, Ebola virus is nonenveloped and is able to survive in the environment for long time; Preventive measures regarding surfaces visibly contaminated with blood and bodily fluids are recommended under the Precautionary Principle	Use of standard hospital detergents and disinfectants (e.g., 0.5% chlorine solution or a solution containing 5000 ppm available free chlorine), preceded by cleaning to prevent inactivation of disinfectants by organic matter, is recommended	Strength of the evidence; Low