14
Management
Î Infected individuals should be counseled to wash hands frequently
with soap and water (as opposed to sanitizer only) and use separate
towels, and to avoid close contact with others during the period of
contagion. (II++, G, S)
Î Avoiding contact with others is especially important for individuals in
professions with high potential for transmission, such as health care
workers and child care providers. (III, G, S)
Î To avoid cross-contamination, multiple-dose eyedrop containers
should be discarded when inadvertent contact with the ocular surface
occurs. (III, G, S)
Î Hand-washing procedures with antimicrobial soap and water
and disinfecting ophthalmic equipment may reduce the risk of
transmission of viral infection. (III, G, S)
Î Exposed surfaces on equipment can be decontaminated by wiping with
sodium hypochlorite or other appropriate disinfectants. (III, I, D)
Î Disinfecting agents recommended for routine decontamination of
tonometer tips include 70% ethyl alcohol and sodium hypochlorite.
(III, G, S)
Î Tonometer tips should be wiped clean and then disinfected by
immersing them for 5–10 minutes in either 70% ethyl ethanol or
1:10 sodium hypochlorite. (II+, G, S)
Î After disinfection, the tonometer should be thoroughly rinsed in tap
water and air dried before use. (II+, G, S)
Î The common practice of wiping the tonometer tip with a 70% isopropyl
alcohol wipe does NOT provide adequate disinfection for a patient who
has adenoviral keratoconjunctivitis. (III, I, D)
Î Disposable tonometer tips can also be considered to eliminate cross
infections. (III, I, D)
Î Intraocular pressure (IOP) can be checked using an applanation
tonometer with a disposable coverlet. (III, I, D)
Î Consideration should be given to possibly deferring IOP measurement
for a patient with acute conjunctivitis. (III, I, D)
Treatment
Î Indiscriminate use of topical antibiotics or corticosteroids should be
avoided, because antibiotics can induce toxicity and corticosteroids
can potentially prolong adenoviral infections and worsen HSV
infections. (III, G, S)
