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Clinical Sciences
September 1998

Disinfection of Eyelid Speculums for Retinopathy of Prematurity Examination

Author Affiliations

From the Departments of Ophthalmology, Cullen Eye Institute (Drs Woodman, Coats, and Paysse), Pediatrics and Pathology (Dr Demmler), and Pathology (Dr Rossmann), Baylor College of Medicine, Texas Children's Hospital, Houston.

Arch Ophthalmol. 1998;116(9):1195-1198. doi:10.1001/archopht.116.9.1195

Objective  To evaluate the effectiveness of 70% isopropyl alcohol swabs in disinfecting eyelid speculums after examination for retinopathy of prematurity .

Methods  Two phases. Phase 1: 46 autoclave-sterilized eyelid speculums randomized into either a cleaned or control group following examination for retinopathy of prematurity. Speculums in the cleaned group were disinfected with a 70% isopropyl alcohol swab while control speculums were not cleaned. Bacterial and fungal cultures were then obtained. Phase 2: 20 autoclave-sterilized eyelid speculums inoculated with a clinically relevant dilution of adenovirus serotype 5 or herpes simplex virus type 2. Inoculated speculums were randomized into either a cleaned or control group.

Results  Phase 1: 17 (70.8%) of 24 cultures from the cleaned group yielded bacteria compared with 21 (95.5%) of 22 controls. Fungi were isolated from only 1 control and from no cleaned speculums. Phase 2: all speculums inoculated with adenovirus supported growth of the organism irrespective of cleaning with 70% isopropyl alcohol swabs. None of 5 cleaned speculums inoculated with herpes simplex virus type 2 supported viral growth, compared with 3 (60%) of 5 cultures positive for growth in the control group.

Conclusion  Cleaning eyelid speculums with 70% isopropyl alcohol swabs provided inadequate disinfection against bacteria following examination for retinopathy of prematurity and against adenovirus in a laboratory simulation.