# Aerosolization ocular surface microorganisms accumulation effect during non-contact tonometer measurements

## TL;DR

This study shows that non-contact tonometry can release and accumulate microorganisms from the eye into the air, increasing the risk of bio-aerosol transmission.

## Contribution

The study demonstrates an accumulation effect of aerosolized ocular microorganisms during repeated non-contact tonometry measurements.

## Key findings

- Pathogenic Aerococcus viridans and other microorganisms from the eye can spread into the air during NCT.
- AOSMs increase in quantity and species with repeated NCT measurements, showing an accumulation effect.
- AOSMs may pose a risk of exposure and transmission in clinical settings.

## Abstract

This study aimed to verify that aerosolization ocular surface microorganisms (AOSMs) accumulated during non-contact tonometry (NCT) measurements.

A total of 508 participants (740 eyes) were enrolled in the study. In Experiment 1, before NCT was performed on each eye, the air was disinfected, and environment air control samples were collected via Air ideal® 3P (Bio Merieux). During NCT measurements, microbial aerosol samples were collected once from each eye. In Experiment 2, we collected initial blank control samples and then repeated Experiment 1. Finally, in Experiment 3, after the background microbial aerosol investigation, we cumulatively sampled AOSMs from each 10 participants then culture once, without any interventions to interrupt the accumulation. The collected samples were incubated and identified using matrix-assisted laser desorption/ ionization time-of-flight mass spectrometry (MALDI-TOF-MS).

Pathogenic Aerococcus viridans and other microorganisms from human eyes can spread and accumulate in the air during NCT measurements. The species and quantity of AOSMs produced by NCT measurements can demonstrate an accumulation effect.

AOSMs generated during NCT measurements are highly likely to spread and accumulate in the air, thereby may increase the risk of exposure to and transmission of bio-aerosols.

The online version contains supplementary material available at 10.1186/s12886-024-03664-7.

Pathogenic Aerococcus viridans and other species of aerosolization ocular surface microorganisms (AOSMs) can spread and accumulate with the increase of NCT measurement person times, demonstrating an accumulation effect.

The online version contains supplementary material available at 10.1186/s12886-024-03664-7.