Cleaning Instructions

Instruments and Equipment

Health Canada adopts Spaulding’s classification system for medical instruments. The method for proper cleaning, disinfection, or sterilization of reusable instruments is based on the potential risk of infection involved in the use of that instrument (Table 2).

Medical instruments and equipment are divided into three classes (see Tables 2 and 3):

1. Critical- Critical items are instruments or objects that routinely penetrate the skin or mucus membranes into normally sterile areas of the body, or come into contact with recirculating body fluids. If not purchased sterile, these objects must be physically cleaned, rinsed, and sterilized before use. Sterilization can be achieved by heat (autoclave) or by chemical sterilization. Instruments must be packaged to maintain sterility.
2. Semicritical - These items come in contact with non-intact skin or intact mucous membranes, but do not ordinarily penetrate normally sterile areas of the body. These objects must be physically cleaned, rinsed, and undergo high-level disinfection before use.
3. Noncritical - These are items that do not ordinarily touch the patient or touch only intact skin. Depending on their use, only physical cleaning and/or low-level disinfection are necessary before reuse.

The majority of ophthalmic equipment would fall into the semi-critical and noncritical categories. Most ophthalmic instruments can, therefore, be sterilized by heat (autoclave) or disinfected by immersion for 10 minutes in one of the following fresh solutions:

1. Hydrogen peroxide (3%)
2. A 1/10 dilution (0.5% solution) of common household bleach (sodium hypochlorite).
3. 70% ethanol or isopropyl alcohol, or alternatively:
4. A chemical germicide approved and labeled for use as a sterilant/disinfectant, following label instructions

The device should be thoroughly rinsed in tap water and dried before reuse.

Alcohol should not be used to soak tonometer (have we previously defined what this is?) bi-prisms or gonioscopic contact lenses (and this?), since it may damage these lens surfaces over time. Hydrogen peroxide would then be the solution of choice. Alternatively, they may also be disinfected with a 70% alcohol swab, rinsed, and air-dried.