Tonometer to Eye Transmission?

[MoogyMoogy]

Hello Dr.,

I am temporarily living abroad. Before I left, I had an eye exam. I have been fearful of HIV for some time, so when I found out that the eye Dr. actually touched my eye with the tonometer (I think the particular method was Goldman tonometry), I became worried about possibly being infected if an HIV+ person had used the machine before me.

I called the eye Dr. two days later and told her about my fear. She seemed a little confused at first, like the thought had never occurred to her. She basically said that there is a cleaning and drying procedure used after patients, and that I shouldn't be worried. I was relieved, but still had some worries nagging at me.

I had nearly put the thing behind me when I got a little sick last week. It had been exactly, or very close to 3 weeks since the eye exam. At first (this past Tuesday) there was just a little tickle in my throat that became a little sore and dry feeling. Then 2 days later, I would feel a little bit nauseous for small periods of the day. On Saturday, I felt like I was almost back to normal, so I took a day trip. Then I felt worse again on Sunday. I felt a little nauseous, dizzy and a little warm, but I took my temperature and it was 98.5', so I guess no fever. On Monday I felt the same, and on Tuesday went to the Dr., who said I had one maybe two viruses, and a bacterial infection (she prescribed some antibiotics). The inside of my ears are a little inflamed, as well as my nose and my throat. I have a single ulcer on my soft palate, and the lymph nodes on my neck feel like they are swelling up just a bit (which has seemed to occur during sickness ever since I got mono last summer).

If I had not known about ARS, I wouldn't be worried. What worries me is the timing of this sickness. That being said, I really don't want to have an HIV test unless it is necessary.

Do eye to eye infections occur?
Do these sound like symptoms of ARS?
Should I get tested?

[Edward W Hook, MD]

Welcome to our Forum.  We don't get many questions that we have not received but at least part of yours is a new one- I have never been asked about the potential for a tonometer to transmit HIV.  Further, as an Infectious Diseases specialist, I am not familiar with tonometry techniques (although my ophthalmologist performs it on me annually).  I can tell you however that there has never been a case of HIV documented to be transmitted by tonometry and that there are a number of reasons why this is unlikely.  

Please remember that HIV s a fragile, short-lived virus which only lives an hour or two in the human body under optimal circumstances.  Outside of the body, in the environment HIV begins to die almost immediately and even under optimal circumstances lives only a few minutes.  Thus, both the interval between patients, the low likelihood  that the patient before you had HIV and the standard cleaning procedures used on tonometers (I am not familiar with what they are) all make even the theoretical possibility of transmission through direct contact effectively zero and not something to worry about.

As for your symptoms, while a sore throat is part of the ARS, nausea is not and you did not have other signs of ARS (fever, rash, severe muscle and joint aches, etc).  Thus I would not worry that the symptoms you mention were due to HIV and instead would attribute them to a spring cold/sore throat of the sort that most people get from time to time.  

there is no reason for concern or for testing related to the events you describe.  I hope you find my comments helpful.  EWH

[Edward W Hook, MD]

Of course, glad to help. EWH

[MoogyMoogy]

Many thanks, Dr. Hook. Have a great day!