Current practice patterns for cleaning tonometry tips and diagnostic/laser lenses

In an online survey of >1000 ophthalmologists, most reported using alcohol wipes or swabs to clean tonometry tips (73%) and diagnostic (63%) or laser (50%) contact lenses. Use of disposable devices or high-level disinfection (HLD) was uncommon and driven largely by facility policies or regulatory requirements. Only 19% of those using HLD did so because they believed it to be safer. Ocular surface toxicity and device damage were commonly seen with HLD. Reports of infection transmission were exceedingly rare, with 99% indicating they had never encountered a case. More than 75% of respondents were strongly opposed, while only 3% strongly supported requiring HLD for tonometry tips and diagnostic or laser lenses. In the absence of evidence that common cleaning methods - such as alcohol wipes or soap and water - pose significant infection risk, the use of HLD for these routine devices should be left to the discretion of ophthalmologists.