As the H1N1 Swine Flu continues to spread pinkeye (conjunctivitis) is still uncommon and very mild. Rare cases have been showing up involving neurological complications that sometimes do manifest other eye problems. Encephalopathy is a neurological syndrome that disrupts large areas of the brain. This has been seen in a limited number of patients and can result in eyes turning up or to the side, usually accompanied by a seizure. Other problems that may be seen in the future with encephalopathy are photophobia (light sensitivity) and nystagmus (eyes rapidly moving in a tremor like manner). By this point the patient would normally be hospitalized from the other problems so it is highly unlikely to be seen in a home setting.
An unknown at this point is if the influenza can be transmitted from the tears in the eye. The normal routes of transmission are through airborne droplets created by coughing or sneezing or touching a surface that has been contaminated. While the HIV virus is present in tears there are no known cases of transmission by this route. It is unknown if this will be the same with the new Flu virus. Also, airborne droplets could contact the eye, drain into the sinuses and possibly result in infection. Until more is known it is probably best to err on the side of caution and wear some form of protective eyewear if you are around someone with flu symptoms.
Swine Flu (H1N1) is starting to creep back into the news and will probably reach TV hysteria by September. I believe it will be a mild version and not have a large impact in the U.S. Even so, we are planning to continue serving your eye care and eye doctor needs if it should become a severe pandemic.
The first thing to consider is isolation as the number one, proven method to stop the spread of flu. During the Spanish Flu Epidemic of 1918 Western Samoa was devastated with 90% of the population infected and high mortality rates. American Samoa was barricaded closed and was flu free. Here in Gunnison, Colorado the train station was closed with similar results.
Isolation works. Flu cycles typically occur for about 6 weeks, returning after months for a few more cycles. That means planning on restricting activities for about 6 weeks. If needed, we have plans to extend refill times on prescriptions and mail glasses or contact lenses directly to your house. For office visits we plan on scheduling every visit, even pick ups, adjustments, or any type of office visit. By reducing the number of people in the office at the same time as you we can greatly reduce exposure. We can also perform more limited exams during the 6 week cycle. We will request you come in alone if at all possible to reduce exposure to our employees. By scheduling all visits we can reduce the number of employees in the office at any given time reducing exposure.
Obviously, if you feel like you might have the flu we would request rescheduling your appointment. While we do have some face masks, there are still questions if they have any effect on preventing transmission. As you might know, most masks are manufactured overseas and difficult to obtain. We may request patients to wear them instead of us to extend the supply we do have. As you may have heard there will be a shortage of vaccine. Unfortunately, in years past most production was moved offshore. The last several years there has been a move to correct this but only 40 million vacines are expected from initial production in October.
Additional measures will be placing hand washing stations by the doors for everyone entering the office, and requesting keeping a three foot distance away from anyone else.
Pinkeye is not a common complication of the H1N1 Flu and there are reports of a number of cases with low or no fevers.
Again, I personally so not expect this to be a serious problem in the U.S. and don’t expect we will need to change our normal procedures, but we are prepared to if needed. Less developed parts of the world have the potential to face a much more grim prospect due to crowding, hygiene, and lack of health care. Probably the worst thing we can expect is the possibility of being stuck at home with kids when the internet or cable goes down!
Stay Well
Dr David Kisling, Optometrist
Conjunctivitis is rarely a specific indicator for Swine Flu. The CDC seems to indicate an abrupt onset of fever (100-100.5) in conjunction with typical flu symptoms is fairly indicative of influenza. There are a number of supposed cases in Mexico of mild H1N1 Flu with low or non recorded fever. It remains to be seen if these are mild cases of flu or Upper Respiratory Infections. Any case of conjunctivitis accompanied with the signs of flu such as dry cough, muscle aches, fatigue lasting more that a few days, loss of appetite, sinus congestion mild or moderate, and headaches should be considered a possiblre case of H1N1 Flu until proven otherwise or until the current outbreak gains clatity. This does not mean all possible cases need to be tested, merely that patients with a questionable diagnosis should stay away from public places a few days inside until it becomes clear they do not have H1N1 Flu. If you have all of the indications of Influenza your Family Optometrist may be willing to treat mild conjunctivitis with a telephone consult to avoid further spred of the virus. As a Fort Collins Eye Doctors Office, we are comfortable treating existing patients with a confirmed diagnosis of H1N1 Flu in this manner in conjunction with your primary care family doctor.
Pinkeye (conjunctivitis) is a rare reported symptom of Swine Flu. It is highly unlikely to be the initial symptom of Swine Flu so rest easy if you have pink eye, it is probably a simple viral or bacterial eye infection easily amendable to treatment.
We Would like to Serve as Your Fort Collins Eye Doctors Office-Please Call 970-226-0959 if You Have Questions About PinkEye or would like to schedule an appointment with a Fort Collins Optometrist.
