title: Contamination of disposable tonometer prisms during tonometry.
abstract: OBJECTIVE
  Due to the theoretical possibility of prion transmission in applanation tonometry, many ophthalmological units in the United Kingdom now use disposable tonometer prisms. We have investigated the potential for bacterial and viral transmission from the health practitioner to the patient via disposable prisms.
  
  
  METHODS
  All staff who perform applanation tonometry at the Sussex Eye Hospital (SEH) received a questionnaire to evaluate if the applanating face of the prism is touched during tonometry and the ease of use of the disposable prism compared to the reusable prisms that were previously used. We then cultured prisms handled by a random sample of staff members for common bacteria. Finally, we constructed a model to investigate the possibility of interpatient adenoviral transmission via disposable tonometer prisms.
  
  
  RESULTS
  The questionnaire revealed that almost 50% of the staff admit to touching the applanating face of the tonometer prism prior to applanation. Cultures of the prisms grew a range of bacteria including Staphylococcus epidermidis, Staphylococcus aureus, and Bacillus species. The viral model suggested that adenovirus could be transmitted by applanation tonometry.
  
  
  CONCLUSIONS
  The use of disposable prisms for applanation tonometry may reduce the risk of prion transmission but is not bacteriologically or virologically aseptic. This is a potential infection risk to patients.
authors.affiliation: Ophthalmology, Sussex Eye Hospital, Brighton, UK. saulrajak@hotmail.com
authors.forename: S N
authors.initials: SN
authors.lastname: Rajak
authors.forename: J
authors.initials: J
authors.lastname: Paul
authors.forename: V
authors.initials: V
authors.lastname: Sharma
authors.forename: S
authors.initials: S
authors.lastname: Vickers
mesh_terms: D000256:Adenoviridae / Q000302:isolation & purification; D000257:Adenoviridae Infections / Q000635:transmission; D001207:Asepsis / Q000592:standards; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000635:transmission; D004209:Disposable Equipment / Q000382:microbiology*; D004866:Equipment Contamination; D015817:Eye Infections / Q000635:transmission*; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient; D011364:Professional Practice / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014065:Tonometry, Ocular / Q000295:instrumentation*