Eye Protection For Infection Control
The Centers for Disease Control and Prevention (CDC) recommends eye protection for a variety of potential exposure settings where workers may be at risk of acquiring infectious diseases via ocular exposure. This document provides background information and specific details on eye protection that can be used to supplement eye protection recommendations provided in current CDC infection control guidance documents. It is intended to familiarize workers with the various types of eye protection available, their characteristics, and their applicable use. Workers should understand that regular prescription eyeglasses and contact lenses are not considered eye protection.
Infectious diseases can be transmitted through various mechanisms, among which are infections that can be introduced through the mucous membranes of the eye (conjunctiva). These include viruses and bacteria than can cause conjunctivitis (e.g., adenovirus, herpes simplex, Staphylococcus aureus) and viruses that can cause systemic infections, including bloodborne viruses (e.g. hepatitis B and C viruses, human immunodeficiency virus), herpes viruses, and rhinoviruses. Infectious agents are introduced to the eye either directly (e.g., blood splashes, respiratory droplets generated during coughing or suctioning) or from touching the eyes with contaminated fingers or other objects.
Eye protection provides a barrier to infectious materials entering the eye and is often used in conjunction with other personal protective equipment (PPE) such as gloves, gowns, masks or respirators.
Appropriately fitted, indirectly-vented goggles* with a manufacturer’s anti-fog coating provide the most reliable practical eye protection from splashes, sprays, and respiratory droplets. Newer styles of goggles may provide better indirect airflow properties to reduce fogging, as well as better peripheral vision and more size options for fitting goggles to different workers. Many styles of goggles fit adequately over prescription glasses with minimal gaps. However, to be efficacious, goggles must fit snugly, particularly from the corners of the eye across the brow. While highly effective as eye protection, goggles do not provide splash or spray protection to other parts of the face.
* Directly-vented goggles may allow penetration by splashes or sprays; therefore, indirectly-vented or non-vented goggles are preferred for infection control.
Face shields are commonly used as an infection control alternative to goggles.** As opposed to goggles, a face shield can also provide protection to other facial areas. To provide better face and eye protection from splashes and sprays, a face shield should have crown and chin protection and wrap around the face to the point of the ear, which reduces the likelihood that a splash could go around the edge of the shield and reach the eyes. Disposable face shields for medical personnel made of light weight films that are attached to a surgical mask or fit loosely around the face should not be relied upon as optimal protection.
** In a chemical exposure or industrial setting, faceshields should be used in addition to goggles, not as a substitute for goggles (ANSI Z87.1-2003 Practice for occupational and educational eye and face protection).
Safety glasses provide impact protection but do not provide the same level of splash or droplet protection as goggles and generally should not be used for infection control purposes.
Full facepiece elastomeric respirators and powered air-purifying respirators (PAPRs) are designed and used for respiratory protection, but because of their design incidentally provide highly effective eye protection as well. Selection of this type of PPE should be based on an assessment of the respiratory hazard in an infection control situation, but will also provide, as an additional benefit, optimal eye protection.
US Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health (NIOSH). Eye Safety – Infection Control – Archived Document, page last reviewed by NIOSH July 29, 2013. Viewed January 2020 https://www.cdc.gov/niosh/topics/eye/eye-infectious.html