Infection control is a foundational competency for paraoptometric professionals. The optometric office involves close patient contact, shared instruments, and procedures near sensitive mucosal surfaces. Proper infection control protects patients from acquiring healthcare-associated infections, protects staff from occupational exposure, and is a regulatory requirement under OSHA standards. Both CPO and CPOA exams include infection control questions covering standard precautions, hand hygiene, instrument reprocessing, and PPE.
Standard Precautions in Optometry
Standard Precautions treat all patient body fluids as potentially infectious—regardless of known diagnosis. In optometry, relevant body fluids include tears, ocular discharge, conjunctival secretions, and blood (rare but possible during foreign body removal).
- Hand Hygiene — Wash before and after every patient, ABHS acceptable when hands not visibly soiled, Critical after removing gloves, 5 Moments of Hand Hygiene (WHO framework)
- Gloves — Wear when touching body fluids, mucous membranes, Change between patients—never reuse, Wash hands after removing gloves, Gloves are NOT a substitute for hand hygiene
- Eye/Face Protection — Wear when splash or spray possible, Safety glasses or face shields during procedures, Particularly important during foreign body removal or eye irrigation
- Respiratory Precautions — Masks for patients with active respiratory illness, Cough etiquette—patient education, Increased precautions during outbreak periods
Instrument Reprocessing: Cleaning, Disinfection, and Sterilization
| Instrument / Item | Level Required | Method |
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Tonometer Tip Disinfection: A High-Priority Area
The Goldmann applanation tonometer tip directly contacts the corneal epithelium. Adenovirus (epidemic keratoconjunctivitis/EKC) is a particularly hardy virus that survives on surfaces and is easily transmitted via inadequately disinfected tonometer tips. The WHO and CDC have specific guidance:
3% Hydrogen Peroxide
Soak tonometer tip for at least 10 minutes. Rinse with sterile saline or distilled water. Air dry or dry with sterile gauze. Effective against adenovirus.
1:10 Sodium Hypochlorite (Dilute Bleach)
1 part household bleach to 10 parts water. Soak for 5 minutes. Rinse thoroughly to remove bleach residue (which is toxic to cornea). Air dry.
70% Isopropyl Alcohol
Wipe with alcohol swab, allow to air dry completely. NOT sufficient for adenovirus—do not use if EKC is suspected.
UV Disinfection
Some practices use UV tip disinfectors. Follow manufacturer protocol for adequate exposure time.
Environmental Cleaning and Room Turnover
- Exam chair (headrest, armrests) — Between each patient — Disposable cover or alcohol wipe for direct contact surfaces
- Trial frame — Between each patient — Alcohol wipe or disinfectant wipe on contact points
- Door handles, light switches — At minimum once per day; more during outbreaks — EPA-registered disinfectant wipe
- Waiting room seating — Daily; immediately if visibly soiled — Disinfectant wipe on vinyl/leather; laundering for fabric
- Reception counter — Several times daily; after each symptomatic patient — EPA-registered disinfectant wipe