Felfeli T, et al. - The use of commercially available slitlamp barriers or breath shields as an added measure of protection recommended by the American Academy of Ophthalmology for reducing the risk of spread of infection to relevant health care professionals from patients who might harbor SARS-CoV-2 in the asymptomatic or presymptomatic period. Researchers conducted a simulation from March 2020 to April 2020, in which they placed an ophthalmologist who had donned standard PPE, including a face mask (ASTM level 2 [3M]) and eye protection (safety glasses [Ultra-Spec 2000]), looking through the oculars of the slitlamp (BM 900 [Haag-Streit]). A commercially available breath shield was there on the slitlamp; it hung on oculars, measured 9.75 inches in width and 10.5 inches in height (Carl Zeiss Meditec AG). At the chin rest of the slitlamp, they placed a manikin (Vera cardiopulmonary resuscitation model [Canadian Red Cross]) to simulate a patient under examination. They simulated a patient cough utilizing a small latex balloon, which was compressed with oxygen and 1.25 mL of washable fluorescent dye that was run through tubing inside the manikin and positioned inside the oral cavity. Observations suggested ejection of up to 2 m away from the patient for large evaporating droplets and 8 m for small evaporating droplets. They support using adjuncts to the current standard PPE and protective barriers, such as breath shields, to reduce cross contamination during slitlamp examinations. These may comprise disposable gowns that give coverage of the shoulders and arms, gloves, and surgical caps for the examiner.