CDC updates COVID-19 eye protection, face mask guidance affecting optometry practices

Two may be better than one when it comes to the public’s face masks, but when it comes to health care personnel, new federal guidance advises medical-grade masks and eye protection when engaged in close patient contact.

On Feb. 10, the Centers for Disease Control and Prevention (CDC) updated its interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic to reflect new guidance for all U.S. health care settings, including optometry practices, that health care personnel in areas with moderate to substantial community transmission are more likely to encounter asymptomatic or pre-symptomatic patients with SARS-CoV-2 and, therefore, should wear eye protection in addition to N95 or equivalent masks when engaged in near-patient work as defined by less than 5 feet.

Even doctors of optometry working in areas with minimal to no community transmission are encouraged to adhere to standard and transmission-based precautions based on anticipated exposures and suspected or confirmed diagnoses, including the use of eye protection, an N95 or equivalent respirator and other personal protective equipment (PPE). Additionally, the CDC notes universal use of a well-fitting facemask for source control is recommended for doctors and patient-facing staff if not otherwise wearing a respirator.

The AOA recommends following guidance from the CDC and local health departments, including wearing masks as practical for patient care in areas with high community levels of covid-19. Doctors seeing patients with known Covid-19 will need to take precautions as they normally would in other exposure situations.

“Gratefully, with more and more doctors of optometry, their staffs and their patients receiving the vaccination against COVID-19, there is certainly light at the end of the tunnel. That said, it would seem that we are not out of the woods yet, particularly with new variants of the virus appearing in all states now,” says Steven Loomis, O.D., AOA HPI chair and AOA past president.

Although optometry practices are well-versed in the PPE recommendations for N95 or equivalent masks after nearly a year of COVID-19 community spread in the U.S., new evidence and recommendations are emerging—particularly regarding the public use of face masks—that when such medical-grade face coverings are unavailable, double-masking with surgical and cloth masks may provide a higher level of protection than from a single mask alone.

In fact, infectious disease expert Anthony Fauci, M.D., noted recently that double-masking likely does provide more protection against SARS-CoV-2, the virus causing COVID-19, as it may cut down on respiratory droplet transmission. While the CDC has yet to issue guidance to that effect, studies show that multilayer cloth masks can prevent up to 50-70% of fine droplets—doctors of optometry will know that N95 masks filter out 95% of airborne particles. For its part, the CDC does recommend that the general public wear well-fitting masks of at least two layers of tightly woven cotton fabric.

Face mask usage remains one of the CDC’s foremost recommendations for preventing SARS-CoV-2 spread, and public health authorities hope to get that message across as worries about community spread of new virus variants dangerously intermingle with a relaxation in public adherence in light of  declining COVID-19 case counts.

Regarding the CDC guidance for health care personnel, Dr. Loomis notes the mask guidance isn’t anything new for doctors of optometry and their paraoptometric staff but the recommendations for eye protection are practically more difficult to accommodate.

“It is difficult if not impossible to conduct many components of an eye examination—BIO, slit lamp, etc.—while wearing a face mask or goggles,” Dr. Loomis says. “Accordingly, the HPI recommends the use of eye protection when it is practicable. The important thing is for doctors to continue to practice as safely as possible for their own health and safety, as well as that of their staff and patients.

“I remain optimistic that we will be in a good place with regard to COVID-19 over the next few months.”

Access AOA’s COVID-19 resources, information

Stay up-to-date with the latest advocacy developments related to federal relief programs and ongoing negotiations with Congress’ next COVID-19 aid package, as well as find relevant information on issues ranging from vaccination efforts to practice guidance at the AOA’s COVID-19 Crisis Response page. Among these resources, doctors might find useful: 

• #AskAOA Update on COVID Vaccines. This #AskAOA webinar provides not only an update on state efforts to vaccinate doctors of optometry but also information related to serving as a COVID-19 vaccinator.
• Doctors of Optometry and Vaccine Administration: The Facts. This AOA fact sheet is available to assist doctors in advocating for their inclusion as eligible COVID-19 vaccinators.
• #AskAOA COVID Relief Update—PPP Second Draw. This #AskAOA webinar provides an in-depth explanation of “second draw” PPP loans, including eligibility requirements, application process, how funds can be used and more.
• Public Health and Epidemiology of COVID-19 for Doctors of Optometry. This AOA HPI paper provides a one-year narrative of the COVID-19 public health emergency and current understanding of the global pandemic as of February 2021.

Learn more about the AOA’s advocacy priorities in Congress’ next COVID-19 aid package and get involved at the AOA’s Online Action Center, or text “RELIEF” to 855.465.5124.