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S. E. Brodie; Upper Bound Estimate of the Rate of Clinic-Acquired Conjunctivitis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):363.
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Recent concern (perhaps exaggerated) over possible transmission of prion diseases and HIV by means of contaminated tonometer prisms has led to the suggestion that single-use sterile tonometer prisms be adopted in place of standard re-usable prisms for routine applanation tonometry. We attempted to estimate the risk of acquired ocular surface infections in a busy urban eye clinic.
The electronic medical record database at the James J. Peters VA Medical Center was queried to identify all patients presenting with a diagnosis of conjunctivitis, eye pain, or ocular inflammation over the most recent five-year interval who had previously visited the eye clinic for any reason.
Out of 76,974 eye clinic visits, and 3,416 patients diagnosed with conjunctivitis, inflammation or eye pain, only four such patients were found. On review of their records, none were in fact diagnosed with conjunctivitis (the diagnoses were blepharitis, keratoconjunctivitis sicca, peri-ocular pain, and conjunctival hemorrhage), and none had been seen in the eye clinic within one year of the presenting visit.
The risk of clinic-acquired conjunctivitis in our center has been less than 1/75,000 visits over the past five years. Analysis of a larger database may allow better estimation of this very small risk. The reduction in risk of transmission of infection through the adoption of single-use tonometer prisms may not justify the expense.
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