High-touch surfaces contributing to infection transmission are particularly concerning in the ophthalmology clinic where frequent contact exists between ophthalmologists and various ophthalmic instruments. Areas of surface contamination from an ophthalmologist’s contact with the slit lamp environment were identified using ultraviolet fluorescence as a surrogate for pathogen contamination. Ultraviolet fluorescent product was applied on the ophthalmologist’s hands after thorough hand washing to indicate the contamination that may be derived from multiple sources in the ophthalmology clinic, such as touching the patient or the patient’s folder during eye examinations and transfers. The ophthalmology clinic was run normally, with the ophthalmologist wiping down patient-contact surfaces on the slit lamp and performing thorough hand hygiene after every patient. Using ultraviolet black light, persistence of surface contamination in the slit lamp environment was identified and evaluated across five days. High-touch surfaces of suboptimal disinfection were inclined towards those touched only by the ophthalmologist, for example: joystick and chin-rest adjustment knob, as compared to patient-contact surfaces. Persistent contamination on the same surfaces revealed inefficacy of current hand hygiene and clinical disinfection practices. This poses a significant risk for pathogen transmission and underscores the importance of including these specific clinician high-touch surfaces in existing cleaning protocols.

Climate change has contributed to changes in disease transmission. In particular, zoonoses such as tick-borne diseases are occurring in areas previously unsuitable for tick survival, with spread to non-endemic areas rising. Ophthalmic manifestations of tick-borne diseases are rare. Often overlooked, diagnosis requires awareness and a high level of suspicion, which may delay treatment. This review provides a comprehensive overview of ocular disease associated with ticks so that management protocols for patients can be designed and implemented. A narrative literature review was conducted. The current literature includes case series, case reports, and literature reviews. Ocular manifestations of tick-borne diseases include adnexal manifestations, conjunctivitis, keratitis, cranial nerve palsies, optic nerve disease, uveitis, exudative retinal detachment, and panophthalmitis, which may occur in isolation or as part of a systemic process. As there is no one constellation of ocular symptoms and signs diagnostic of tick-borne eye diseases, a systematic approach is recommended with particular attention to significant travel and exposure history. In this review, we identify significant risk factors and propose management strategies for afflicted patients to improve treatment outcomes while maintaining cost-effectiveness. Ophthalmologists and generalists will benefit from increased awareness of ocular manifestations of tick-borne diseases in the age of modern travel and climate change.