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HCW with multiple exposures: I cant believe my "eyes"!
Jul 21, 2011

Dear Dr. Frascino, Please shed some light on this as I truly appreciate your advice. I am a dentist from Brazil who sustained multiple eye exposures during procedures. I know that it is difficult to believe, but I was wearing goggles in two occasions. I will summarize each accident: 1-I was wearing my regular spectacles when the water containing some blood managed to reach one of my eyes. I was treating a 13-year-old girl. As she was my cousin, it would be embarrassing to request an HIV test; 2-This time I had safety goggles over my regular spectacles. I was removing calculus on a 16-year-old boy when water and blood managed to reach one of my eyes. I could not believe that as I had 2 glasses on. I cleaned with water and requested a rapid HIV test from the boy according to local health authorities. He was HIV negative. 3-I was treating a 15-year-old girl who had received 2 liters of blood during a craniofacial surgery in the past. This time I was wearing 3 protections: my regular small spectacles, the safety goggle and a face shield. Somehow the air-water spray made its way till one of my eyes. There was no visible blood in the mouth, but the patient had a healing sutured incision from an extraction 5 days ago. It was a typical healing oral incision (with fibrin, plaque, pus and perhaps invisible blood). I could even feel how cold the water was when it reached my eye, so I am sure that my eye was exposed again. I cleaned with water and, this time, I was so embarrassed in front of my assistants that I did not even report the incident. I am definitely a worried well who tests for HIV 3 months after any possible incident. This drives me crazy! I am seeing a psychologist now. I need to find a safety google who seals the area around my eyes completely. This is very difficult because I also need my correction spectacles. Please let me know if I need to get tested after these incidents. Because you are also a HCW, I wonder if you know of any type of safety goggle that completely protects me from these splashes. Thanks for reading this! I am relieved for at least talking about this as people around me think that it is impossible for this to be happening despite of so much protection. God bless you!

Response from Dr. Frascino

Hello, Dentist from Brazil.

The HIV-acquisition risk from the three potential occupational exposures you describe is essentially nonexistent. The primary reason even to consider testing would be to gain psychological peace of mind.

Continue to work with your psychologist regarding your irrational fears surrounding HIV. Universal precautions will protect you from blood-borne illnesses, including HIV. There are a wide range of safety goggles that offer excellent protection, including some for folks who also need glasses. Your problem is not an unusual number of exposures, but rather an irrational response to incidents that pose no real HIV risk.

Dr. Bob



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