The Slit Lamp Shield has been designed to provide a large barrier surface area between clinicians and patients sitting in close proximity during slit lamp examination. The innovative patented side wings permit unhindered access to the slit lamp controls, and allow the clinician to perform usual slit lamp tasks including Goldman Application Tonometry, slit lamp lens retinal examinations, goniscopy and procedures such as suture and foreign body removal.
A recent article assessing the efficacy of slit lamp barrier devices tested only a small and large barrier, but both were flat in design without side panels. The authors wrote:
"The benefits of larger shields should be weighed against the increased risk of fomite transmission, especially where they cause the user to touch the sides in order to perform tonometry or manipulate the slit lamp arm." Poostchi, A., Kuet, M., Pegg, K. et al. Efficacy of slit lamp breath shields. Eye (2020)
Similarly, a recent article published in the AJO used a cardboard slit lamp and spray gun to test several sizes of flat shield, and a model with a edges that curved inwards made from the plastic lid of a salad container. The authors wrote:
"A breath shield that curves towards the examiner...might better protect the examiner's face from eccentric sneezes." Liu J, Wang AY, Ing EB. Ing ED. Efficacy of slit lamp breath shields. AJO (2020)
The American Academy of Ophthalmology Coronavirus advice has encouraged the use of commercially made slit lamp breath guards, as part of an overall infection control strategy. The AAO has warned that "Homemade barriers may be more difficult to sterilize and could be a source of contamination".
The following photo demonstrates a comparison of the size of the Slit Lamp Shield vs the official Haag-Streit downloadable A3 template. Note when reaching to access the application tonometer with the official Haag-Streit template, accidental touching of the shield is often unavoidable. Being made from a light-weight plastic film, this could have the potential to scatter droplets a larger distance each time. In contrast, there is separation to the acrylic Slit Lamp Shield.
Some of the large DIY shields we have seen made online measure up to 45cm x44cm (approx 17.3 inch x 17.7inch). An example of a large DIY shield advocated online is shown. Note the application tonometer is completely blocked from view.
We simulated this with a white corflute board to assess ease of use and feel the photo speaks for itself.