The effect of wearing N95 respirator masks on intraocular pressure of health care workers

Objective@#We determined if there was a significant change in the intraocular pressure (IOP) of healthcare workers with extended use of N95 masks.@*Methods@#This was a prospective time-series study involving 58 eyes of 29 healthcare workers who were assigned to 3 groups: surgical mask (control) and 2 intervention arms consisting of valved N95 (8511, 3M, USA) and non-valved N95 (8210, 3M, USA) masks. Each participant underwent IOP measurements of both eyes by Goldmann applanation tonometry at baseline, 5 minutes, 1 and 4 hours of mask use on three separate days. The primary outcome was the difference in IOP between the N95 and surgical mask groups.@*Results@#Mean baseline IOP of the cohort was 13.85 ± 1.11 mmHg with no significant difference among the groups. Compared to surgical mask use, mean IOP was increased at the 1 hour and 4 hour time points with valved N95 use (+0.88, p<0.001; +1.48, p<0.001 respectively) and increased at the 5 minute, 1 hour and 4 hour time points with nonvalved N95 use (+0.52, p=0.01; +1.07 p<0.001; +1.62, p<0.001, respectively).@*Conclusion@#There was a statistically significant increase in IOPs with prolonged N95 mask use. However, the levels of IOP increase were less than 2 mmHg and may be not clinically significant.

Implementation and pilot data on diabetic retinopathy in a teleophthalmology program at a multispecialty primary care clinic

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To report on the implementation and initial pilot data of diabetic retinopathy (DR) identified using a validated telemedicine program for DR in a multispecialty primary care clinic.<br /><strong>METHODS:</strong> This was a retrospective, cross-sectional pilot survey of diabetic patients imaged for the first time at the telemedicine program of The Medical City from November 26, 2012 to August 31, 2013. The retinal images were obtained following the validated program of the Joslin Vision Network nonmydria. tic fundus photography for DR evaluation. These were evaluated by 4 retina specialists using a standardized protocol to assess for diabetic retinal disease and the presence of other retinal findings. The findings were recorded on customized electronic templates.<br /><strong>RESULTS:</strong> Seven hundred seventy-six (776) eyes of 388 patients were evaluated using the telemedicine program. The prevalence of DR was 28.2% (219 eyes), with 25.1% (195 eyes) having nonproliferative DR (NPDR). 14.2% 1110 eyes] had mild, 8.2% [64 eyes] moderate, 2.2% [17 eyes] severe, and 0.5% [4 eyes] very severe NPDR. 3.1% (24 eyes) had proliferative DR (PDR), of which 45.8% (11 eyes) had high-risk characteristics. The ungradable rate with selective mydriasis was 1.80% (14 eyes). The rate of referable DR (moderate NPDR or worse, any level of diabetic macular edema, or ungradable images) was 21.90% (170 eyes).<br /><strong>CONCLUSION:</strong> In the primary care setting, teleophthalmology can effectively identify patients with diabetic retinal complications and potentially refer these patients to appropriate levels of eye care. Retinopathy was present in over 28% of patients evaluated and over 21% had referable disease that may potentially progress to vision loss. Teleophthalmology for DR in this setting allows early detection of potentially sight threatening disease and may prevent visual loss and complications.</p>