Effects of baffle and intraocular pressure on aerosols generated in the noncontact tonometer measurement during COVID-19
Authors:   The Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China, Tang Yuan , Li Chun-Chun ,   The Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China, Chen Zhang-Yan ,   The Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China, Chen Chen ,   The Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China, Wen Si-Qi ,   The Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China, Huang Xiao-Qiong ,   The Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China, Qu Jia ,   The Eye Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China, Chen Yan-Miao ,   The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo 315000, Zhejiang Province, China, Chen Ai-Ai ,   The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo 315000, Zhejiang Province, China
Published: March 2022

AIM: To investigate the effects of baffle and intraocular pressure (IOP) on the aerosols generated in the noncontact tonometer (NCT) measurement and provide recommendations for the standardized use of the NCT during coronavirus disease 2019 (COVID-19).
METHODS: This clinical trial included 252 subjects (312 eyes) in The Eye Hospital, Wenzhou Medical University from March 7, 2020, to March 28, 2020. Sixty subjects (120 eyes) with normal IOP were divided into two groups. One group used an NCT without a baffle, another group used an NCT with a baffle. Another 192 subjects (192 eyes) were divided into four groups: Group A1 (without a baffle+normal IOP), Group A2 (without a baffle+high IOP), Group B1 (with a baffle+normal IOP) and Group B2 (with a baffle+high IOP). Particulate matter (PM) 2.5 and PM10 generated by all subjects were quantified during the NCT measurement. The IOP values were recorded simultaneously. Effects of baffle and IOP on aerosols generated during the NCT measurement were analyzed.
RESULTS: In the normal eye group with a baffle, the aerosol density decreased in a wave-like shape near the NCT with the increase in the number of people measured for IOP, demonstrating no cumulative effect. However, in the normal eye group without a baffle, there was a cumulative effect. PM2.5 and PM10 in Group A2 were higher than Group A1 (both P&#x003C;0.001). The PM2.5 and PM10 in Group B2 were higher than Group B1 (P&#x003C;0.01, P&#x003C;0.001 respectively). The PM10 of Group B1 was lower than Group A1 (P&#x003C;0.01). PM2.5 in Group B2 were lower than Group A2 (P&#x003C;0.01). The median of per capita PM2.5 and PM10 in the combined Group A1+A2 were 0.80 and 1.10 μg/m3 respectively, which were higher than 0.20 and 0.60 μg/m3 in the combined Group B1+B2 (both P&#x003C;0.01). The median of per capita PM2.5 and PM10 in the combined Group A1+B1 were 0.10 and 0.20 μg/m3 respectively, which were lower than 1.30 and 1.70 μg/m3 in the combined Group A2+B2 (both P&#x003C;0.001).
CONCLUSION: More aerosols could be generated in patients with high IOP. After the NCT is equipped with a baffle, per capita aerosol density generated decreased significantly near the NCT; And with the increase in the number of people measured for IOP, the aerosols gradually dissipated near the NCT, demonstrating no cumulative effect. Therefore, it is suggested that the NCT should be equipped with a baffle, especially for patients with high IOP.