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Letters to the Editor

New challenges and workaround

Ultrasound biomicroscopy in time of COVID-19 pandemic

Jayasree, PV; Sathidevi, AV; Kiran, Anjali1; Sanjay, Srinivasan2

Author Information
Indian Journal of Ophthalmology: July 2020 - Volume 68 - Issue 7 - p 1496-1497
doi: 10.4103/ijo.IJO_1793_20
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Dear Editor:

Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection associated respiratory disease – COVID-19 (2019-nCoV) is currently a pandemic involving more than 151,767 infected patients in India,[1] and over 5,404,512 cases all over the world.[2] Reports have shown the likelihood of disease transmission through the ocular secretions of patients.[3] All ocular procedures have to be undertaken focusing on protecting the patient and the medical worker. Ultrasound biomicroscopy being a high-resolution ultrasound technique which allows non-invasive in-vivo imaging of the anterior ocular segment is an inevitable investigation in ophthalmology.[4]

Technique of UBM: Ultrasound biomicroscopy is performed with patient lying in supine position. After topical anaesthesia, an eyecup is placed and is filled with a sonolucent coupling fluid to form a water bath. The probe oscillates within this open water bath.[4]

The procedure poses some risks of exposure to the examiner and the patient. We herein recommend solutions to the possible risks in Table 1.

Table 1
Table 1:
Possible risks of exposure and its solutions during UBM

We also made a small but significant change for the person performing the UBM as shown in [Fig. 1a and b]. It is advised that these extra steps can be implemented to safeguard our medical workers and protect our patients during these trying times.

Figure 1
Figure 1:
(a) Face shield covers examiner's face from front, with opening from below and the sides. (b) The same face shield worn from below; covers examiner's face from below and reduces exposure while performing UBM with patient in supine position

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Conflicts of interest

There are no conflicts of interest.

1. Last accessed on 2020 May 27 Available from:
2. Last accessed on 2020 May 27 Available from:
3. Lu CW, Liu XF, Jia ZF. 2019-nCoV transmission through the ocular surface must not be ignored Lancet. 2020;395:e39
4. He M, Wang D, Jiang Y. Overview of ultrasound biomicroscopy J Curr Glaucoma Pract. 2012;6:25–53
5. Guidelines for Glaucoma Management during COVID times, Version 1.0, w.e. f. May 11th, 2020. Tejwani S, Angmo D, Nayak BK, Sharma N, Sachdev MS, Sinha R. AIOS Working Committee. Ophthalmic practice guidelines in the current context of COVID 19 All India Ophthalmological Society.
    © 2020 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow