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      Tele-consultations in the wake of COVID-19 – Suggested guidelines for clinical ophthalmology

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          Abstract

          While telemedicine has been around for a few decades, it has taken great importance and prominence in recent times. With the fear of the virus being transmitted, patients and physicians across specialties are using consultation via a telephone call or video from the safety of their homes. Though tele-ophthalmology has been popular for screening, there are no clear guidelines on how to comprehensively manage patients seeking advice and treatment for a particular eye condition. Some major barriers to diagnosis and management are compromised detailed examination, no measurement of the visual acuity or intraocular pressure and a retinal evaluation not being feasible. Despite these limitations, we do need to help those patients who need immediate care or attention. Hence, this article has put together some guidelines to follow during such consultations. They are important and timely due to the medicolegal and financial implications.

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          Most cited references42

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          IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040.

          To produce current estimates of the national, regional and global impact of diabetes for 2015 and 2040.
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            Coronavirus infections and immune responses

            Abstract Coronaviruses (CoVs) are by far the largest group of known positive‐sense RNA viruses having an extensive range of natural hosts. In the past few decades, newly evolved Coronaviruses have posed a global threat to public health. The immune response is essential to control and eliminate CoV infections, however, maladjusted immune responses may result in immunopathology and impaired pulmonary gas exchange. Gaining a deeper understanding of the interaction between Coronaviruses and the innate immune systems of the hosts may shed light on the development and persistence of inflammation in the lungs and hopefully can reduce the risk of lung inflammation caused by CoVs. In this review, we provide an update on CoV infections and relevant diseases, particularly the host defense against CoV‐induced inflammation of lung tissue, as well as the role of the innate immune system in the pathogenesis and clinical treatment.
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              Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS‐CoV‐2 infection

              Abstract Objective This study aimed to assess the presence of novel coronavirus in tears and conjunctival secretions of SARS–CoV‐2‐infected patients. Methods A prospective interventional case series study was performed, and 30 confirmed novel coronavirus pneumonia (NCP) patients were selected at the First Affiliated Hospital of Zhejiang University from 26 January 2020 to 9 February 2020. At an interval of 2 to 3 days, tear and conjunctival secretions were collected twice with disposable sampling swabs for reverse‐transcription polymerase chain reaction (RT‐PCR) assay. Results Twenty‐one common‐type and nine severe‐type NCP patients were enrolled. Two samples of tear and conjunctival secretions were obtained from the only one patient with conjunctivitis yielded positive RT‐PCR results. Fifty‐eight samples from other patents were all negative. Conclusion We speculate that SARS‐CoV‐2 may be detected in the tears and conjunctival secretions in NCP patients with conjunctivitis.
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                Author and article information

                Journal
                Indian J Ophthalmol
                Indian J Ophthalmol
                IJO
                Indian Journal of Ophthalmology
                Wolters Kluwer - Medknow (India )
                0301-4738
                1998-3689
                July 2020
                25 June 2020
                : 68
                : 7
                : 1316-1327
                Affiliations
                [1]Narayana Nethralaya Eye Institute, 121/C, Chord Road, Rajajinagar, Bengaluru, Karnataka, India
                Author notes
                Correspondence to: Dr. Chaitra Jayadev, Vitreo-Retina Consultant, Narayana Nethralaya Eye Institute, 121/C, Chord Road, Rajajinagar, Bangalore, Karnataka - 560 010, India. E-mail: drchaitra@ 123456hotmail.com
                Article
                IJO-68-1316
                10.4103/ijo.IJO_1509_20
                7574118
                32587157
                711c07ae-bc79-4789-ae7f-3860926a6eea
                Copyright: © 2020 Indian Journal of Ophthalmology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 15 May 2020
                : 09 June 2020
                : 09 June 2020
                Categories
                Preferred Practice

                Ophthalmology & Optometry
                covid-19,medicolegal,tele-consultation,tele-ophthalmology,video consultation

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