Covid-19 Guidelines

Covid-19 Frequently Asked Questions

There was never a directive that optometric practices close in Ohio. In fact, the Stay at Home order specifically referenced eye care centers, including those that sell glasses and contact lenses, as essential service providers. Many optometrists continued to remain open delivering emergency and essential services and have already implemented many of the safety protocols listed in the OOA Guidelines. Reopening dates and the level of care an office provides should follow the office’s documented plan for providing a safe environment, and the comfort levels of the doctor and patients in providing care.

Because eye care was deemed essential from the outset and optometric practices were never forced to close, it is unlikely that state government will issue a statement informing optometrists to “reopen” as that would be unnecessary.

What about the CDC recommendation on delaying routine eye care?

A little over a month ago, the CDC recommended to delay routine eye and dental care. The recommendation was made due to safety concerns over eye care professionals being in close proximity to patients without protection, and the need to preserve protective equipment for the front-line health care workers treating COVID-19 patients in hospital settings. According to the AOA, the CDC recommendation on deferring routine eye care is no longer in effect.

As outlined in Ohio’s Stay at Home orders, the provision of eye care services is essential for the state’s residents and has been delivered safely for patients with emergency and essential needs by Doctors of Optometry since the beginning of the pandemic. The State of Ohio is beginning The Path Forward to Restart which balances Public Health Measures and Compliance, Businesses Operating Safely with Safeguards, and Protecting the Most Vulnerable.

Core Principle 1: Patient and Visitor Screening.

Optometric practices should screen patients, visitors and staff members for symptoms of COVID-19 upon their arrival at the facility.

1. All patients and staff members will have their temperature measured. Anyone measuring at or above 100.4 F will not be allowed into the facility unless a true ocular emergency exists. Patient and employee temperatures should be documented as part of their record.
2. Any staff member showing signs of COVID-19 will not be permitted to work and will be referred to an appropriate healthcare provider.
3. Patients and visitors exhibiting signs of COVID-19 will be rescheduled, unless an emergency dictates otherwise, and referred to an appropriate healthcare provider.
4. When scheduling appointments, staff will discuss with patients the need to reschedule their appointment if they develop fever or symptoms of COVID-19 leading up to the time of their appointment.
5. Patients and visitors to the office will be informed in advance of the expectation that they wear their own mask or cloth face covering upon arrival to the office. If not, they will be denied entrance into the office. When we are able to obtain additional face coverings, we will offer a mask or cloth face covering to patients who don’t have them at a minimal charge. They should also be instructed that if they must touch or adjust their cloth face covering, they should perform hand hygiene immediately before and after. Masks and cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or anyone who is unconscious, incapacitated or otherwise unable to remove the mask without assistance. At this time, we are not going to schedule patients that are unable to wear a mask unless a true ocular emergency exists.
6. Any required caregiver entering the facility should be documented in the patient’s chart to track who is in the building. This information can also be used for contact tracing in the event of a COVID-19 flare-up.

 

Core Principle 2: Physical Distancing Measures

Every attempt will be made so that individuals maintain six feet of distance between each other when practical. This will be accomplished with the following measures:

1. Appointments will be arranged to try reduce the number of patients in the dispensary by decreasing the number of comprehensive exams per hour to 2 from 3.
2. Dispensing glasses and adjustments will be scheduled to have more control over the number of patients in the dispensary at a time so that six-foot distancing can be accomplished.
3. Patients will be asked to call or text the office upon arrival so entrance to and movement through the facility can be coordinated by staff.
4. Upon entering, patients will be taken back to an exam room as soon as any paperwork is turned in and insurance cards scanned so that they will not spend time in the waiting room.
5. We will instruct patients that companions should remain outside of the facility and not accompany the patient unless they are a parent/guardian of the patient or if they are a true care giver and need to assist the patient.
6. Continue curbside dispensing when possible, and at-home delivery of contact lenses.
7. We will limit the number of people in the building at one time to 50% of the maximum allowed by fire code. We will limit the number of patients and staff members within the optical dispensary area at any one time.
8. All paperwork, including patient history forms, will be made accessible to patients prior to appointments for completion through a secure link on the internet. If patients do not have internet access, we may consider mailing the forms to patients or obtaining information over the phone.

 

Core Principle 3: Infection Control and Disinfection Practices

Optometric practices must take steps to help prevent the spread of the virus through infection control measures and disinfection practices.

1. Hand sanitizer and other sanitary products will be readily available for employees and patients throughout the facility.
2. Staff will be instructed to work from only one workstation and using one telephone whenever possible. If another workstation must be used, it should be properly cleaned before and after use.
3. We will continue to use germicidal wipes to clean exam chairs and all equipment after every patient encounter.
4. At noon and the end of the day, we will perform enhanced environmental cleaning of commonly touched surfaces, such as workstations, counters, railings, door handles, clipboards, pens, chairs and other public area surfaces.
5. Care will be taken in the handling of eyeglass frames and other products to limit opportunities for the transfer of the virus. All frames touched by a patient will be placed on a tray to be disinfected prior to being placed back on display. We will consult with frame representatives regarding proper care of frames so as not to cause damage, and follow CDC guidance on disinfection methods for these items.
6. UV sterilization boxes will be obtained to aid in the sterilization of frames, PPE, and other appropriate items.
7. Contact lens cases for patient use will be stored in a drawer to prevent exposure to airborne virus particles prior to use
8. All items in the exam room touched by the technician, doctor, or patient will be set out on the counter for proper disinfection prior to another patient entering the room
9. Commercially available sanitizers and disinfectants will be used when available by following the directions on the label. In addition, diluted bleach may be used on appropriate hard surfaces. To make a diluted bleach solution, mix 5 tablespoons (1/3 cup) of bleach per gallon of water; or 4 teaspoons of bleach per quart (32oz) of water; or 3 teaspoons of bleach per 24oz of water. The solution should be left on the surface for at least 1 minute.

 

Core Principle 4: Protective Measures

We are making every attempt to obtain Personal Protective Equipment for doctors and staff.

1. All doctors and staff members are required to wear masks and can consider consider wearing gloves and protective eyewear when interacting with patients and coworkers. Some equipment may be unavailable due to shortages and we will utilize the best methods available to provide protection for patients and staff members.
2. Patients and visitors to the office will be informed in advance of the expectation that they wear their own mask or cloth face covering upon arrival to the office. If not, they will be denied entrance into the office. When we are able to obtain additional face coverings, we will offer a mask or cloth face covering to patients who don’t have them at a minimal charge. They should also be instructed that if they must touch or adjust their cloth face covering, they should perform hand hygiene immediately before and after. Masks and cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or anyone who is unconscious, incapacitated or otherwise unable to remove the mask without assistance. At this time, we are not going to schedule patients that are unable to wear a mask unless a true ocular emergency exists.
3. Doctors and staff members should wash hands before and after each patient encounter. Any gloves which are utilized during patient care should be properly removed and disposed of after each patient encounter.
4. A barrier shield will be used around testing equipment when possible, including slit-lamp barriers or breath shields and pupillometer breath shields.
5. Staff members will receive instruction on how to safely touch or adjust their mask or cloth face covering and performing hand hygiene immediately before and after.
6. Barrier plexiglass sheets will be installed at the front desk to provide additional protection for patient interactions in that area.

We will regularly reinforce key messages – stay at home when ill, use cough and sneeze etiquette, and practicing regular hand hygiene – to all staff members and consider placing posters reiterating these issues in areas where they are most likely to be seen.