Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.
Front Public Health. 2020 Nov 12;8:599757. doi: 10.3389/fpubh.2020.599757. eCollection 2020.
SARS-CoV-2 is a coronavirus with high infectivity and has caused dramatic pressure on health systems all over the world. Appropriate personal protection for medical staffs is critical. For ocular protection, there is ongoing hot debate and concern for potential ocular transmission of SARS-CoV-2. Ocular manifestations and positive detection of viral RNA in ocular samples were only reported in very small number of patients infected with SARS-CoV-2. However, health care workers need to face patients more closely and have higher risk of aerosol contamination. Thus, appropriate ocular protection for medical workers is still recommended by organizations such as WHO and American Academy of Ophthalmology. Although eye goggles provide excellent protection and are mandatory for medical practitioners with high risk of exposure, they are not ideal for common clinical practice, because they can disturb vision due to extensive formation of water droplets and frequently cause moderate to severe discomfort after longtime wearing, which have been reported to interfere with working status. For the majority of medical workers who don't deal with high risk patients, they are not advised to wear goggles in daily practice. However, they also face the risk of infection due to the presence of asymptomatic carriers. Especially in situations with high risk of ocular exposure, such as close physical examination, eye surgery, dental clinics and surgery, ocular protection may be needed. Griffithsin has been shown to directly bind to spike proteins and has anti-viral activity against a broad spectrum of viruses, including coronavirus. Griffithsin is found to inhibit the entry of SARS-CoV at relatively low concentration and is stable and non-toxic. SARS-CoV-2 and SARS-CoV share the same entry receptors and their spike proteins are similar in conformation. We hypothesize that contact lenses containing nanoparticles loaded with griffithsin may provide sufficient ocular protection for medical staffs without high risk of exposure during the outbreak period of SARS-CoV-2. If proven effective, griffithsin-loaded contact lens can be considered as a supplementary ocular protective equipment for medical workers who can tolerate well. The daily disposable contact lens should be applied as needed and refrain from extended wearing in order to reduce potential side effects.
SARS-CoV-2 是一种具有高传染性的冠状病毒，已对全球卫生系统造成巨大压力。为医务人员提供适当的个人防护至关重要。对于眼部防护，人们对 SARS-CoV-2 可能通过眼部传播存在持续的热议和担忧。仅在少数感染 SARS-CoV-2 的患者中报告了眼部表现和眼部样本中病毒 RNA 的阳性检测。然而，医护人员需要更近距离地面对患者，并且气溶胶污染的风险更高。因此，世界卫生组织和美国眼科学会等组织仍建议医务人员进行适当的眼部防护。虽然护目镜能提供极好的保护，并且是高暴露风险医务人员的强制性装备，但它们并不适合常规临床应用，因为护目镜会因广泛形成的水滴而严重干扰视力，并且长时间佩戴后会经常引起中度至重度不适，据报道还会干扰工作状态。对于大多数不接触高危患者的医务人员，不建议他们在日常工作中佩戴护目镜。但是，由于存在无症状携带者，他们也面临感染的风险。特别是在存在高眼部暴露风险的情况下，如近距离体格检查、眼部手术、牙科诊所和手术，可能需要眼部防护。Griffithsin 已被证明可直接与刺突蛋白结合，并对包括冠状病毒在内的广谱病毒具有抗病毒活性。Griffithsin 被发现以较低的浓度抑制 SARS-CoV 的进入，并且稳定且无毒。SARS-CoV-2 和 SARS-CoV 使用相同的进入受体，其刺突蛋白在构象上相似。我们假设含有负载 griffithsin 的纳米颗粒的隐形眼镜可为在 SARS-CoV-2 爆发期间无高暴露风险的医务人员提供足够的眼部保护。如果被证明有效，那么载有 griffithsin 的隐形眼镜可被视为可耐受的医务人员的补充眼部防护设备。应按需使用日抛型隐形眼镜，并避免长时间佩戴，以减少潜在的副作用。
