Use of eye protection for healthcare

workers

What is the rationale and evidence for using eye protection?

Ocular (eye) transmission is a potential route of occupational acquisition for healthcare and other frontline workers.
Eye protection has been associated with a lower risk of infection.
In the context of the coronavirus (COVID-19) pandemic, the use of eye protection is required for healthcare workers
who are in direct patient / resident / client-facing roles with individuals who are suspected or confirmed cases of
COVID-19 or in quarantine for any reason (for example as a close contact of a case or after recent travel). The
rationale for eye protection is:
• it protects the mucous membranes of the eyes from potential contamination with particles and body fluids that
may contain the coronavirus (COVID-19) virus
• it prevents people from touching their eyes and face to avoid infection acquisition
• it reduces the risk of being furloughed from work should you have close contact with a patient later diagnosed
with coronavirus (COVID-19).

What are eye protection options?

Eye protection options include face shields, goggles and safety glasses.
When wearing an P2/N95 respirator, it is important to select the proper eye protection to ensure that the respirator
does not interfere with the correct positioning of the eye protection, and that the eye protection does not affect the
fit or seal of the respirator. Therefore, staff should have eyewear available at the time of fit testing.

Goggles and safety glasses

Closely fitted wrap-around goggles or safety glasses that meet Australian standards (AS/NZS 1337.1:2010) should
be worn for all face-to-face contact by healthcare workers. When worn correctly they protect the wearer from direct,
droplet and aerosol transmission. Usual prescription glasses, contact lenses or safety glasses that are not wrap-
around do not provide adequate protection and are therefore not suitable.
Goggles with a manufacturer’s anti-fog coating provide reliable and practical eye protection from splashes, sprays,
and respiratory droplets that can come from multiple angles. Newer styles of goggles fit adequately over
prescription glasses with minimal gaps (to be efficacious goggles must fit snugly, particularly from the corners of
the eye across the brow). Other types of protective eyewear include safety glasses with side-shield protection,
which are widely used in other specialties that use operating microscopes.

Face shields
Single-use or reusable face shields may be used as an alternative to goggles or safety glasses. Face shields are
particularly useful for splashes and sprays of blood or body fluids, depending on the type of work performed. All
face shields should provide a clear plastic barrier that covers the face. They should extend below the chin
anteriorly, to the ears laterally, and there should be no exposed gap between the forehead and the shield’s
headpiece. Face shields which have a gap between the forehead and the headpiece are unsuitable for use in the
operating theatre, birthing suite, or when certain aerosol-generating procedures are performed on coronavirus
(COVID-19) cases (unless additional eye protection is worn under the face shield). These shields are however an
appropriate form of eye protection in non-high-risk areas.

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Options for healthcare workers with prescription glasses or contact lenses
Options for wearers of prescription glasses include various brands of goggles (such as clear acetate non-vented
3M Fahrenheit goggles) which may be worn over prescription glasses, or alternatively safety goggles with
prescription lenses, or a face shield.

Advantages and disadvantages of different types of eye protection

Advantages of fitted wrap-around goggles and safety glasses include:
• they have a flexible frame to easily fit contours of the face
• they provide good eye protection by enclosing the eyes
• they can accommodate an adjustable band, so they don’t become loose during clinical activity
• some types of safety glasses have a clear plastic lens with fog and scratch resistant treatment
• prescription safety glasses may be ordered,
Disadvantages of goggles and safety glasses include:
• wearing them for prolonged periods may increase the risk of skin injuries, particularly if they seal too tightly
• they do not provide additional splash or spray protection to the face or mask / respirator
• they do not deter the wearer from touching the front of their mask, face or respirator
• they may not be able to be worn over prescription glasses
• prescription safety glasses are not single use and require cleaning
• they may become scratched over time
• there is a higher risk of fogging.
Advantages of face shields include:
• they can be worn over prescription glasses
• they have an adjustable band to attach firmly around the head and fit snuggly against the forehead
• they provide additional blood or body fluid splash / spray/droplet protection to the face and mask / respirator
(thereby prolonging the life of the mask/respirator)
• the wearer’s eyes can be seen more easily which may be important when caring for some residents / patients /
clients
• there is less risk of fogging
• the wearer is less likely to touch their face / mask.
Disadvantages of face shields include:
• gaps to the sides and underneath may allow virus-contaminated droplets to reach mucous membranes if not
worn with a well-fitting mask at the same time
• face shields which have a gap between the forehead and the shield’s headpiece do not provide adequate eye
protection from splashes of blood or body fluids
• face shields do not wrap-around the eyes and therefore are not as protective as other eyewear.
NOTE: Face shields are nota replacement for wearing a mask or respirator.

How to remove protective eyewear

When eye protection is removed, regardless of the type, the wearer should remove glasses / goggles from the tip of
the arms or the strap from the back of the head and avoid touching the face near the eyes.

How to clean and disinfect protective eye wear

Protective eyewear labelled as ‘single-use’ should be discarded after use and not reused. Ideally eye protection
should be issued for individual use only. Eye protection must be thoroughly cleaned and disinfected after each use
even if being reused by the same person.
When cleaning and disinfecting reusable protective eyewear follow the manufacturer’s cleaning instructions.

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The Australian Department of Health have proposed two options for cleaning and disinfecting reusable eye
protection; cleaning and disinfection by individuals of their own protective eyewear or disinfection of batches of
protective eyewear. Further information can be found on the Department of Health’s website
<https://www.health.gov.au/resources/publications/iceg-guidelines-on-cleaning-and-disinfection-of-protective-
eyewear-in-health-and-residential-care-facilities>.

Option 1: Cleaning and disinfection of reusable protective eyewear by individual health

and other care workers
1. Carefully wipe the inside and then the outside using a clean cloth saturated with a detergent solution or a wipe.
2. Carefully wipe the outside using a clean cloth saturated with a TGA-registered hospital disinfectant solution
with virucidal claims, or TGA-registered disinfectant wipe <https://www.tga.gov.au/disinfectants-use-against-
covid-19-artg-legal-supply-australia>. Disinfectant should be left for the contact time specified in the
manufacturer’s instructions to be effective.
3. Wipe the outside with a disposable clean cloth dampened with tap water to remove residue. To improve
visibility, protective eyewear may also be wiped with alcohol.
4. Dry thoroughly (air dry on individual hooks allocated to individual health and other care workers which do not
allow eyewear to touch one another or use clean absorbent towels).
5. Place protective eyewear in a ‘breathable’ storage receptacle.
6. Perform good hand hygiene by washing your hands thoroughly with water and soap (or a soap solution) or an
alcohol-based hand rub.

Option 2: Mass disinfection of reusable protective eye wear

1. Eyewear should be initially cleaned by the wearer after removal using a detergent or a detergent disinfectant
wipe.
7. Place used eyewear into a bag or container to be transferred to an area where high-volume disinfection can
occur.
8. Perform good hand hygiene by washing your hands thoroughly with water and soap (or a soap solution) or
waterless antimicrobial agent.
9. Gloves should be worn by the person cleaning the eyewear. Eye protection can also be worn if there is a
chance that splash may occur.
10. Place all eyewear in a container with a detergent solution and clean all surfaces with a clean disposable cloth
then dry with a separate clean disposable cloth.
11. Carefully wipe the outside of each item using a wipe or clean cloth saturated with TGA-registered hospital
disinfectant solution with virucidal claims, or TGA-registered disinfectant wipe. Disinfectant should be left for
the contact time specified in the manufacturer’s instructions to be effective.
12. Wipe the outside of each item with a disposable clean cloth dampened with tap water to remove residue.
13. Each item should be carefully dried, avoiding contamination from the previous step, for example, by a different
person wearing gloves (hand hygiene before putting on and after removal).
14. Store items in a dry location for redistribution.

To find out more information about coronavirus and how to stay safe visit
DHHS.vic – coronavirus (COVID-19)
<https://www.dhhs.vic.gov.au/coronavirus>
If you need an interpreter, call TIS National on 131 450

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For information in other languages, scan the QR code or visit
DHHS.vic –Translated resources - coronavirus (COVID-19)
<https://www.dhhs.vic.gov.au/translated-resources-coronavirus-disease-
covid-19>

For any questions

Coronavirus hotline 1800 675 398 (24 hours)
Please keep Triple Zero (000) for emergencies only

To receive this document in another format phone 1300 651 160 using the National Relay
Service 13 36 77 if required, or email the Department of Health and Human Services
COVID19InfectionControl (DHHS) <COVID19InfectionControl@dhhs.vic.gov.au>

Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne.

© State of Victoria, Australia, Department of Health and Human Services, 1 December 2020.
Available at: DHHS.vic – Infection Prevention Control <https://www.dhhs.vic.gov.au/infection-prevention-control-
resources-covid-19>

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