101
|
Wong RL, Ting DS, Wan KH, Lai KH, Ko CN, Ruamviboonsuk P, Huang SS, Lam DS, Tham CC. COVID-19: Ocular Manifestations and the APAO Prevention Guidelines for Ophthalmic Practices. Asia Pac J Ophthalmol (Phila) 2020; 9:281-284. [PMID: 32739937 PMCID: PMC7480794 DOI: 10.1097/apo.0000000000000308] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/02/2020] [Indexed: 01/08/2023] Open
Abstract
The World Health Organization declared the Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 a "Pandemic" on March 11, 2020. As of June 1, 2020, Severe Acute Respiratory Syndrome Coronavirus 2 has infected >6.2 million people and caused >372,000 deaths, including many health care personnel. It is highly infectious and ophthalmologists are at a higher risk of the infection due to a number of reasons including the proximity between doctors and patients during ocular examinations, microaerosols generated by the noncontact tonometer, tears as a potential source of infection, and some COVID-19 cases present with conjunctivitis. This article describes the ocular manifestations of COVID-19 and the APAO guidelines in mitigating the risks of contracting and/or spreading COVID-19 in ophthalmic practices.
Collapse
Affiliation(s)
- Raymond L.M. Wong
- C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong
- C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, Guangdong, China
- Department of Ophthalmology, The University of Hong Kong, Hong Kong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Daniel S.W. Ting
- Singapore Health Service (SingHealth), Duke-NUS Medical School, Singapore
| | - Kelvin H. Wan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Kenny H.W. Lai
- C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong
- C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, Guangdong, China
| | - Chung-Nga Ko
- C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong
- C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, Guangdong, China
| | - Paisan Ruamviboonsuk
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Suber S. Huang
- Retina Center of Ohio, Cleveland, OH, USA
- Bascom Palmer Eye Institute, Miami, FL
| | - Dennis S.C. Lam
- C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong
- C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, Guangdong, China
- International Eye Research Institute of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China
| | - Clement C.Y. Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
102
|
Abstract
BACKGROUND Healthcare work is a risk factor for coronavirus disease 2019 (COVID-19). OBJECTIVES To review risk mitigation strategies in ophthalmology during the COVID-19 pandemic. MATERIAL AND METHODS Risk mitigation strategies to maintain ophthalmology care, to prevent collateral damage from care disruption, and to prevent the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are summarized based on the example of a tertiary referral center in Germany. RESULTS Clinical management strategies included restricted access to buildings, triage systems, telemedicine approaches, strategies for rapid treat and release, and transparent communication strategies. Strategies to protect patients and staff relied on both standard hygiene precautions and the use of personal protective equipment for prevention of droplet infections. Physical barriers supported risk mitigation strategies. CONCLUSION To maintain ophthalmological care during the COVID-19 pandemic, a coordinated, multifaceted approach using risk mitigation strategies to protect staff, patients, and the public was initiated.
Collapse
Affiliation(s)
- Katrin Wacker
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - Thomas Reinhard
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| |
Collapse
|
103
|
Bakshi SK, Ho AC, Chodosh J, Fung AT, Chan RVP, Ting DSW. Training in the year of the eye: the impact of the COVID-19 pandemic on ophthalmic education. Br J Ophthalmol 2020; 104:1181-1183. [PMID: 32586935 PMCID: PMC7577089 DOI: 10.1136/bjophthalmol-2020-316991] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | - Allen C Ho
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania, USA
| | - James Chodosh
- Ophthalmology, Massachusetts Eye and Ear, Howe Laboratory, Harvard Medical School, Boston, Massachusetts, USA
| | - Adrian T Fung
- Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - R V Paul Chan
- Retina, Illinois Eye and Ear Infirmary, Chicago, Illinois, USA
| | - Daniel Shu Wei Ting
- Vitreo-Retinal Department, Singapore National Eye Center, Singapore, Singapore
| |
Collapse
|
104
|
Zhou L, Xu Z, Castiglione GM, Soiberman US, Eberhart CG, Duh EJ. ACE2 and TMPRSS2 are expressed on the human ocular surface, suggesting susceptibility to SARS-CoV-2 infection. Ocul Surf 2020; 18:537-544. [PMID: 32544566 PMCID: PMC7293510 DOI: 10.1016/j.jtos.2020.06.007] [Citation(s) in RCA: 222] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 05/24/2020] [Accepted: 06/11/2020] [Indexed: 01/01/2023]
Abstract
Purpose Conjunctival signs and symptoms are observed in a subset of patients with COVID-19, and SARS-CoV-2 has been detected in tears, raising concerns regarding the eye both as a portal of entry and carrier of the virus. The purpose of this study was to determine whether ocular surface cells possess the key factors required for cellular susceptibility to SARS-CoV-2 entry/infection. Methods We analyzed human post-mortem eyes as well as surgical specimens for the expression of ACE2 (the receptor for SARS-CoV-2) and TMPRSS2, a cell surface-associated protease that facilitates viral entry following binding of the viral spike protein to ACE2. Results Across all eye specimens, immunohistochemical analysis revealed expression of ACE2 in the conjunctiva, limbus, and cornea, with especially prominent staining in the superficial conjunctival and corneal epithelial surface. Surgical conjunctival specimens also showed expression of ACE2 in the conjunctival epithelium, especially prominent in the superficial epithelium, as well as weak or focal expression in the substantia propria. All eye and conjunctival specimens also expressed TMPRSS2. Finally, Western blot analysis of protein lysates from human corneal epithelium obtained during refractive surgery confirmed expression of ACE2 and TMPRSS2. Conclusions Together, these results suggest that ocular surface cells including conjunctiva are susceptible to infection by SARS-CoV-2, and could therefore serve as a portal of entry as well as a reservoir for person-to-person transmission of this virus. This highlights the importance of safety practices including face masks and ocular contact precautions in preventing the spread of COVID-19 disease.
Collapse
Affiliation(s)
- Lingli Zhou
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhenhua Xu
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gianni M Castiglione
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Uri S Soiberman
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Charles G Eberhart
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pathology, Johns Hopkins University School of Medicine, USA.
| | - Elia J Duh
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
105
|
Bourdon H, Jaillant R, Ballino A, El Kaim P, Debillon L, Bodin S, N'Kosi L. Teleconsultation in primary ophthalmic emergencies during the COVID-19 lockdown in Paris: Experience with 500 patients in March and April 2020. J Fr Ophtalmol 2020; 43:577-585. [PMID: 32564983 PMCID: PMC7284250 DOI: 10.1016/j.jfo.2020.05.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/07/2020] [Accepted: 05/12/2020] [Indexed: 11/30/2022]
Abstract
This prospective observational cohort study is based on the first 500 patients who requested emergency teleconsultation during the initial days of the COVID-19 lockdown in Paris, France between 20 March and 10 April 2020. It is the first study to assess the utility of emergency teleophthalmology with a simple smartphone application or web browser and a webcam to manage emergency eye care in a population with sudden restricted access to ophthalmologists. In this study, every patient who asked for an ophthalmic emergency consultation in a single specialized center in Paris (‘SOS Œil’) first had to undergo a teleconsultation appointment to evaluate the indication for a physical consultation to preserve lockdown. Under medical advice only, a physical appointment was given within a day (if necessary). The aim of the study was to describe the population and diagnoses and evaluate the main judgment criteria, defined as the ‘ability of teleconsultation to properly indicate a physical consultation for fair diagnosis and treatment in eye emergencies’. This organization has permitted physicians and patients to preserve social distancing while avoiding 3 or 4 physical consultations per person. Notably, 27% of teleconsultations were followed by a physical appointment. There was a mean 4.12-day delay between symptom apparition and consultation, and less than 1 day for traumas, superficial corneal foreign body and neuro-ophthalmological emergencies. There was a 96% sensitivity and 95% specificity to properly evaluate the indication of a physical consultation and only 1.0% misdiagnoses that lead to delayed care. Hence, teleconsultation maintained satisfactory healthcare access to patients with severe ophthalmological disorders while preserving social distancing and sanitary precautions. Therefore, teleconsultation may be seriously considered as a way to efficiently regulate ophthalmic emergencies, especially for patients with limited access to a specialist.
Collapse
Affiliation(s)
- H Bourdon
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28, rue de Charenton, 75012 Paris, France; OphtalmoPôle Cochin, 8, rue Méchain, 75014 Paris, France.
| | - R Jaillant
- Centre Ophtalmologique Paris 17 - SOS Œil, 33-35, rue de Chazelles, 75017 Paris, France
| | - A Ballino
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28, rue de Charenton, 75012 Paris, France
| | - P El Kaim
- OphtalmoPôle Cochin, 8, rue Méchain, 75014 Paris, France
| | - L Debillon
- OphtalmoPôle Cochin, 8, rue Méchain, 75014 Paris, France
| | - S Bodin
- OphtalmoPôle Cochin, 8, rue Méchain, 75014 Paris, France
| | - L N'Kosi
- Centre Ophtalmologique Paris 17 - SOS Œil, 33-35, rue de Chazelles, 75017 Paris, France
| |
Collapse
|
106
|
Murnain KL, Ooi JL, Sharma NS. Evaluation of the Slit Lamp Shield to reduce droplet exposure. Clin Exp Optom 2020; 103:555-556. [PMID: 32452068 PMCID: PMC7283659 DOI: 10.1111/cxo.13096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Kaila L Murnain
- Department of Ophthalmology, Eye and Retina Specialists, Sydney, Australia
| | - Ju-Lee Ooi
- Department of Ophthalmology, Eye and Retina Specialists, Sydney, Australia
| | - Neil S Sharma
- Department of Ophthalmology, Eye and Retina Specialists, Sydney, Australia
| |
Collapse
|
107
|
Khan MA, Sivalingam A, Haller JA. Perceptions of Occupational Risk and Changes in Clinical Practice of United States Vitreoretinal Surgery Fellows during the COVID-19 Pandemic. Ophthalmol Retina 2020; 4:1181-1187. [PMID: 32450265 PMCID: PMC7255129 DOI: 10.1016/j.oret.2020.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE To assess perceptions of occupational risk and changes to clinical practice of ophthalmology trainees in the United States during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN An anonymous, nonvalidated, cross-sectional survey was conducted online. Data were collected from April 7 through 16, 2020. PARTICIPANTS Second-year U.S. vitreoretinal surgery fellows in two-year training programs were invited to participate. METHODS Online survey. MAIN OUTCOME MEASURES Survey questions assessed policies guiding COVID-19 response, exposure to severe acute respiratory syndrome coronavirus 2, changes in clinical duties, and methods to reduce occupational risk, including availability of personal protective equipment (PPE). RESULTS Completed responses were obtained from 62 of 87 eligible recipients (71.2% response rate). Training settings included academic (58.1%), hybrid academic/private practice (35.5%), and private practice only settings (6.5%). Overall, 19.4% of respondents reported an exposure to a COVID-19-positive patient, 14.5% reported self-quarantining due to possible exposure, and 11.3% reported being tested for COVID-19. In regards to PPE, N95 masks were available in the emergency room (n = 40 [64.5%]), office (n = 35 [56.5%]), and operating room (n = 35 [56.5%]) settings. Perceived comfort level with PPE recommendations was significantly associated with availability of an N95 respirator mask in the clinic (P < 0.001), emergency room (P < 0.001), or operating room (P = 0.002) settings. Additional risk mitigation methods outside of PPE were: reduction in patient volume (n = 62 [100%]), limiting patient companions (n = 59 [95.2%]), use of a screening process (n = 59 [95.2%]), use of a slit-lamp face shield (n = 57 [91.9%]), temperature screening of all persons entering clinical space (n = 34 [54.84%]), and placement of face mask on patients (n = 33 [53.2%]). Overall, 16.1% reported additional clinical duties within the scope of ophthalmology, and 3.2% reported being re-deployed to nonophthalmology services. 98.4% of respondents, 98.4% expected a reduction in surgical case volume. No respondents reported loss of employment or reduction in pay or benefits due to COVID-19. CONCLUSIONS Suspected or confirmed clinical exposure to COVID-19-positive patients occurred in approximately one fifth of trainee respondents. Perceived comfort level with PPE standards was significantly associated with N95 respirator mask availability. As surgical training programs grapple with the COVID-19 pandemic, analysis of trainees' concerns may inform development of mitigation strategies.
Collapse
Affiliation(s)
- M Ali Khan
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Mid Atlantic Retina, Philadelphia, Pennsylvania; Department of Ophthalmology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.
| | - Arunan Sivalingam
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Mid Atlantic Retina, Philadelphia, Pennsylvania; Department of Ophthalmology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Julia A Haller
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Department of Ophthalmology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| |
Collapse
|
108
|
Veritti D, Sarao V, Bandello F, Lanzetta P. Infection control measures in ophthalmology during the COVID-19 outbreak: A narrative review from an early experience in Italy. Eur J Ophthalmol 2020; 30:621-628. [PMID: 32418481 PMCID: PMC7265098 DOI: 10.1177/1120672120927865] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction The novel coronavirus (SARS-CoV-2) is infecting people and spreading easily from person-to-person. Cases have been detected in most countries worldwide. Italy is one of the most affected countries as of 30 March 2020. Public health response includes a rapid reorganization of the Italian National Healthcare System in order to reduce transmission of COVID-19 within hospitals and healthcare facilities, while optimizing the assistance to patients with severe COVID-19 complications. Methods We analysed the actions that were taken in three ophthalmology centres in northern Italy during the SARS-CoV-2 outbreak and how these measures affected patient’s attendance. In addition, due to the rapidly evolving scenario, we reviewed the evidence available during the course of this pandemic. Results A full reorganization of ophthalmology services is mandatory according to current existing infection containment measures in order to continue dispensing urgent procedures without endangering the community with amplification of the diffusion chain. Ophthalmologists are considered at elevated risk of exposure when caring patients and vice versa, due to their close proximity during eye examination. High volumes of procedures typically generated by ophthalmologists with concurrent implications on the risk of infection are considered when re-assessing healthcare facilities reorganization. Conclusion Containment measures in the event of pandemic due to infective agents should be well known by healthcare professionals and promptly applied in order to mitigate the risk of nosocomial transmission and outbreak.
Collapse
Affiliation(s)
- Daniele Veritti
- Department of Medicine - Ophthalmology, University of Udine, Udine, Italy.,Department of Ophthalmology, Ospedale Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Valentina Sarao
- Department of Medicine - Ophthalmology, University of Udine, Udine, Italy.,Department of Ophthalmology, Ospedale Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.,Istituto Europeo di Microchirurgia Oculare (IEMO), Udine, Italy
| | - Francesco Bandello
- Vita-Salute San Raffaele University, Milan, Italy.,IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Lanzetta
- Department of Medicine - Ophthalmology, University of Udine, Udine, Italy.,Department of Ophthalmology, Ospedale Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.,Istituto Europeo di Microchirurgia Oculare (IEMO), Udine, Italy
| |
Collapse
|
109
|
Zhou L, Xu Z, Castiglione GM, Soiberman US, Eberhart CG, Duh EJ. ACE2 and TMPRSS2 are expressed on the human ocular surface, suggesting susceptibility to SARS-CoV-2 infection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2020:2020.05.09.086165. [PMID: 32511393 PMCID: PMC7263540 DOI: 10.1101/2020.05.09.086165] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
PURPOSE Conjunctival signs and symptoms are observed in a subset of patients with COVID-19, and SARS-CoV-2 has been detected in tears, raising concerns regarding the eye both as a portal of entry and carrier of the virus. The purpose of this study was to determine whether ocular surface cells possess the key factors required for cellular susceptibility to SARS-CoV-2 entry/infection. METHODS We analyzed human post-mortem eyes as well as surgical specimens for the expression of ACE2 (the receptor for SARS-CoV-2) and TMPRSS2, a cell surface-associated protease that facilitates viral entry following binding of the viral spike protein to ACE2. RESULTS Across all eye specimens, immunohistochemical analysis revealed expression of ACE2 in the conjunctiva, limbus, and cornea, with especially prominent staining in the superficial conjunctival and corneal epithelial surface. Surgical conjunctival specimens also showed expression of ACE2 in the conjunctival epithelium, especially prominent in the superficial epithelium, as well as the substantia propria. All eye and conjunctival specimens also expressed TMPRSS2. Finally, western blot analysis of protein lysates from human corneal epithelium obtained during refractive surgery confirmed expression of ACE2 and TMPRSS2. CONCLUSIONS Together, these results indicate that ocular surface cells including conjunctiva are susceptible to infection by SARS-CoV-2, and could therefore serve as a portal of entry as well as a reservoir for person-to-person transmission of this virus. This highlights the importance of safety practices including face masks and ocular contact precautions in preventing the spread of COVID-19 disease.
Collapse
|
110
|
Suryawanshi MP, Saidi RA. Staring down the barrel of COVID-19. Oman J Ophthalmol 2020; 13:55-56. [PMID: 32792798 PMCID: PMC7394079 DOI: 10.4103/ojo.ojo_87_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 04/18/2020] [Indexed: 11/04/2022] Open
|
111
|
Abstract
Coronavirus disease 2019 (COVID-19) is caused by a highly contagious RNA virus termed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Ophthalmologists are at high-risk due to their proximity and short working distance at the time of slit-lamp examination. Eye care professionals can be caught unaware because conjunctivitis may be one of the first signs of COVID-19 at presentation, even precluding the emergence of additional symptoms such as dry cough and anosmia. Breath and eye shields as well as N95 masks, should be worn while examining patients with fever, breathlessness, or any history of international travel or travel from any hotspot besides maintaining hand hygiene. All elective surgeries need to be deferred. Adults or children with sudden-onset painful or painless visual loss, or sudden-onset squint, or sudden-onset floaters or severe lid oedema need a referral for urgent care. Patients should be told to discontinue contact lens wear if they have any symptoms of COVID-19. Cornea retrieval should be avoided in confirmed cases and suspects, and long-term preservation medium for storage of corneas should be encouraged. Retinal screening is unnecessary for coronavirus patients taking chloroquine or hydroxychloroquine as the probability of toxic damage to the retina is less due to short-duration of drug therapy. Tele-ophthalmology and artificial intelligence should be preferred for increasing doctor-patient interaction.
Collapse
Affiliation(s)
- Parul Chawla Gupta
- Department of Ophthalmology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - M Praveen Kumar
- Department of Pharmacology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Jagat Ram
- Department of Ophthalmology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| |
Collapse
|
112
|
Coping with COVID-19: An Italian Perspective on Corneal Surgery and Eye Banking in the Time of a Pandemic and Beyond. Ophthalmology 2020; 127:e68-e69. [PMID: 32376056 PMCID: PMC7177097 DOI: 10.1016/j.ophtha.2020.04.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/16/2020] [Accepted: 04/21/2020] [Indexed: 11/23/2022] Open
|