[Prevention of infections in the ophthalmology office]. / Prévention des infections au cabinet ophtalmologique.

ABSTRACT

Transmission of infectious agents from a patient to the following one in the medical office may result from infected collyria, from contact to the cornea by infected instruments or simply by the hands of the medical staff if some rules of hygiene are not respected. The prevention comprises the instillation without contact of the collyria, the adequate disinfection of instruments and the frequent hand washing. The disinfection of the tonometers and contact glasses aims particularly the elimination of viruses. If the virus of herpes, hepatitis and acquired immunodeficiency are eliminated by hypochlorite, oxygenated water and alcohol after 10 minutes, the adenovirus which is not coated is on the other hand resistant to alcohol and may survive several days on instruments. Ideally the disinfection would have to be performed between each utilization by soaking in bleach water at 500 ppm, or in chloramine 0.5%, or in hydrogen peroxide 3% (during 10 minutes). The alcohol may damage the glue of diagnostic contact lens. The hypochlorite attacks the metal. In case of possible contact with the blood of the patient, the wear of gloves is counseled (for example for fluorescein angiography) and is of course mandatory for surgical procedures in the office like excision of chalazion or keratotomy. Disposable needles will be thrown in solid wall containers reserved to this aim without being recapped.