Introduction
’, cough, infection, deaths, sneezes
TRANSMISSION, INFECTION
Transmission of COVID-19 within ophthalmology clinics is recognised as a significant danger to both patients and staff members. The sustained close proximity of patients to healthcare workers in enclosed (and sometimes poorly ventilated) ophthalmology clinics leads to high levels of droplet and aerosol contamination [Evidence suggests that person-to-person transmission occurs through droplets, or aerosols, of infected saliva and respiratory secretions when a person coughs, sneezes or talks [The use of ophthalmic equipment, such as the slit lamp biomicroscope or direct ophthalmoscope, require close working distances. Common transmission routes for COVID-19 are from droplets or aerosols, via the eye [Patient infection risk may also be great, and it should be recognised that 25–30% of all COVID-19 deaths are thought to have originated from health care workers, many of whom are asymptomatic [To mitigate these risks, patients have been encouraged to wear face-masks and health care workers have worn PPE. Other methods include increased ventilation and physical barriers or ‘breath-guards’ to prevent a direct spray between patient and staff [The Portsmouth group has developed a number of methods for generating a cough model, and detecting the spray of droplets in different clinical situations. We stain droplets with fluorescein, and use forensic imaging techniques to photograph the droplets. Droplets were counted using image analysis techniques in the Institute of Cosmology and Gravitation.We performed a randomised controlled trial of a control group with no shield vs ‘breath-guard’ vs ‘breath-guard and face-mask’ to measure the effectiveness of the breath-guard on droplet contact with the clinician. In the remainder of this paper, we refer to the ‘breath-guard and face-mask group’ as simply the ‘breath-guard group’.