Focus on Ebola: Managing the Ocular Effects of the Disease

EbolaBy Evra Taylor

With the continuing Ebola Virus Disease (EVD) crisis in West Africa, all eyes are focused on survival, as they should be. As of October 2014, the disease had already claimed the lives of more than 3,000 citizens, according to the World Health Organization.

EVD was first identified in 1976 but there have been more cases and deaths in this outbreak than in all the others combined. In fact, the Ebola crisis is reported to be the worst the world has ever seen. “The average case fatality rate is 50 per cent, which is significantly higher than the lowest level of previous outbreaks, which ranged from approximately 25 to 90 per cent.”

Some of the symptoms of EVD, such as body aches, fever, vomiting and cough, are the same as those of the flu. However, patients may present with more serious symptoms like chest pain and bleeding, both internally and externally, including bleeding from the eyes.

Moreover, optometrists travelling abroad to provide healthcare support for those afflicted face the possibility of contracting the disease. In terms of transmission through tears or contact lenses, the information is inconclusive. It is not yet known whether tears or tear fluid on a contact lens can carry the EVD virus.

Reasonable and Responsible Precautions

One mode of transmission is direct contact with the body or bodily fluids of an infected person, whether living or deceased. Additionally, EVD can be transmitted through indirect contact, through objects, surfaces, clothing or bedding contaminated by the body fluids of a live or deceased infected person.

Healthcare workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced. Careful adherence to health guidelines is essential in addressing the challenges posed by Ebola and helping to minimize the spread of the virus. The World Health Organization’s guidance for care of patients with Ebola, published in September 2014, states: “Strengthen and carefully apply standard precautions when providing care to ALL patients, regardless of the signs and symptoms they present with. This is especially important because the initial manifestations of hemorrhagic fever may be non-specific. Hand hygiene is the most important measure. Gloves should be worn for any contact with blood or body fluid. Medical mask and goggles or a face shield should be used if there is any potential for splashes of blood or body fluids to the face, and cleaning of contaminated surfaces is paramount.”

The federal government reports that there have been no cases of Ebola in Canada and that the risk to Canadians remains very low. Canada’s new Chief Public Health Officer, Dr. Gregory Taylor, has stated that this country has been preparing for the possibility of Ebola cases emerging as the result of overseas travel.

“Canada is well prepared with a number of systems in place to identify and prevent the spread of serious infectious diseases like Ebola, such as working closely with our international partners to gather and assess information and administering the Quarantine Act at all points of entry into Canada,” Dr. Taylor said in a statement.

“The Public Health Agency of Canada is working closely with its provincial and territorial partners and the agency’s National Microbiology Laboratory is well connected with its network of provincial labs to ensure Canada is ready to detect and respond quickly.”

Canadian ECPs are justified in reassuring their patients about the low risk of contracting Ebola. However, in light of the disease’s 21-day incubation period, the importance of high-level precautions cannot be overestimated.