The Correlation between Hands Hygiene before Doing Eye Exercise

and Eye Diseases Diagnostic Rates

HaoSu Chen

, Chen Yuan, YongShan Du, Han Xiao and Yue Huang

Guangzhou foreign language school, China

Keywords: Ophthalmitis, Keratitis, Eye Exercises, Hands Hygiene, Infection.

Abstract: Many eye diseases such as keratitis and ophthalmitis that occur in China harm the eye health of the

public.This study research the relationship between the hands and the potential infection rate of

ophthalmitis and keratitis without reaching the degree of cleanliness during their eye exercises. This study

mainly used two methods: questionnaire and experimental method. The experimental group was group 1

and the control group was group 2. Group 1 washed their hands before doing eye exercises, while Group 2

did not wash their hands before doing eye exercises.Subjects in group 2 were found to have a higher

potential prevalence of ophthalmitis, keratitis.Therefore, it is believed that when doing eye exercises, the

substandard cleanliness of the hand will improve the potential risk of student infection of ophthalmitis and

keratitis. The purpose of this study is to publicize the relationship between hand cleanliness and

ophthalmitis and keratitis, reduce the risk of infection in students while doing eye exercises, and protect eye

health.

1 INTRODUCTION

There is a lot of literature on ophthalmatitis, how

keratitis occurs and whether contact by hand when

doing eye exercises is a good way. Basically, one

point of view is to make less contact with your

hands and your eyes. It is also mentioned that the

use of surgical disinfection or quick dry hand

sanitizer can indeed effectively antivirus bacteria

(Liu 2020, Chen 2012, Zhang 2020)，because the

eye is an exposed organ, where the cornea, lens,

vitreous are avascular transparent tissue, their own

resistance is weak, very vulnerable to the invasion of

microorganisms. Most of the infections with

conjunctivitis are caused by no attention to hand

hygiene. Some articles say that most of the infection

with conjunctivitis is caused by no attention to hand

hygiene because of many hands and eye contact

during eye exercises. If the hand does not fit the

degree of cleanliness, then it may cause

conjunctivitis and keratitis in the eyes of the (Gao

2019). Some people have done experiments on the

relationship between visual eye exercises and eye

exercises and eye infections. Eye care eye exercises

https://orcid.org/0000-0002-3889-1924

is an eye exercise but does not need the hand to

touch the eyes.Article concluded whether the eyes

are hand touched is an important cause of

conjunctivitis, so do exercises do not let hand

contact can effectively alleviate the occurrence of

keratitis (Li 2020, Huang 2013). People also

mentioned that conjunctivitis is mainly by contact

transmission, contact with hand bacteria

transmission (Wang 2012). People also directly

mentioned although high hand bacteria rate before

washing hands, but after washing hands, hand

bacteria rate greatly reduced, they show that this is a

good way to reduce hand bacteria infection (Li

2011). In this paper, in the effect of simplifying the

three-step washing method on the effect of sanitary

hand disinfection, the three-step washing method

refers to the use of three-step washing hands, which

is easier than the six-step washing method.In her

article, she opposed the idea that the group can only

use seven-step washing techniques to achieve

cleanliness(Gu 2020). Many papers supporting the

hypothesis of this study, among which the analysis

of hand health cognitive status and influencing

factors in ophthalmic patients is the most supportive

group. Overall, the above literature section does not

use one hand to support the production of

conjunctivitis is mainly caused by bacteria in the

Chen, H., Yuan, C., Du, Y., Xiao, H. and Huang, Y.

The Correlation between Hands Hygiene before Doing Eye Exercise and Eye Diseases Diagnostic Rates.

DOI: 10.5220/0011371500003438

In Proceedings of the 1st International Conference on Health Big Data and Intelligent Healthcare (ICHIH 2022), pages 417-423

ISBN: 978-989-758-596-8

417

hand. In two eye exercises and children eye

conjunctival infection, and use the data is separate,

just the second grade students as an experimenter, he

only selected a subject, through a grade data is

unscientific, because he is the default age this

variable, which makes the experiment has

accidental, is not universal.It makes the final

conclusion not universal. We will avoid this

limitation as much as possible when we do

experiments. We will send questionnaires for

statistics, interview individual students, and select

cross-grades and schools.Although there are views

to support the groups, there are also opposition

groups.We want to refer to this part of the opinion,

but the author still want to study the analysis of the

data to draw a conclusion.

2 RESEARCH METHODS

Through the data collection process of our group, we

obtained the questionnaire data and the experimental

detection data, and will take descriptive statistical

analysis, chi-square analysis, correlation analysis

and other methods to study the relationship between

different variables and differences, use the collected

data to verify the study hypothesis, and obtain

relevant conclusions about the study.For the

questionnaire data, the study will be presented using

the chart in the descriptive statistics, with the

objectives of the questionnaire design: to investigate

the current attitude of school teenagers about eye

exercise and the understanding of hand health

affecting eye health during eye exercise. The

understanding of the knowledge of periocular

pathogenic bacteria and the hand washing habits of

eye health exercises were regression and analyzed.

Do not pay attention to hand cleaning before doing

eye exercises

For the experimental data, we will first perform

the average t-test of the number of hand colonies in

the control group and the experimental group to

explore whether the number is significantly different

between the hand and the eye.If there is a significant

difference in the number of hand colonies, the

seven-step wash with hand sanitizer is significant,

but the reasons for the significant difference in the

number of periocular colonies need to be further

explored.Regarding the effect of hand washing

opponents and the positive rate of peripheral eye

tests (positive criteria:> 10CFU / cm

), square

analysis will be used.Chi-square analysis can

determine whether hand washing is significantly

different in the positive rate of hand and eye

circumference, so we can verify the conjecture that

hand cleaning before eye exercises can effectively

prevent hand bacteria landing around the eye and

cause harm to eye health.The validation was also

performed using a control experimental method.A

total of 40 subjects were divided into control and

experimental groups of 20 individuals each.The

experimental group performed a hand cleaning using

a seven-step wash, without treatment in the control

group. Hand flora was sampled from 40 students.A

cotton swab soaked in 0.03mol/L phosphate buffer

or saline sampling solution was rubbed back and

forth from both hands finger root to finger end

twice. The cotton swab was sampled, cut off the

hand contact site, and put the cotton swab into the

test tube containing 10ml sampling liquid for

inspection. After the experimental group and control

group began to do eye exercises, after the two

groups of the eye skin quickly samples: will have

saline cotton swab in the eye exercises skin rub 3~5

times, turn the sampling cotton swab, cut off the

hand contact site, the cotton swab into the tube

containing 10ml sampling fluid.All experimental

collected samples were handed over to the third

party testing company "Golden domain" for

inspection.

3 RESULT

3.1 Statistical Analyses

A survey on hand hygiene and hand cleaning found

that 44.38% of students would not understand the

complete seven-step washing method, nearly

92.31% of students wash their hands for less than 30

seconds, indicating that there is a considerable year.

Some students do not understand the scientific and

effective methods of hand washing, and the hand

washing time is relatively short, can not be

guaranteed more

Good hand hygiene, fingertips and nails in the

normal state is likely to hide a lot of fine fungus. In

the survey of the understanding of pathogenic

bacteria leading to eye diseases, 42% of students did

not know their hands at all. On the potential eye

disease treatment of bacteria, 47% of the students

have a certain understanding of the existence of eye

disease pathogenic bacteria, only 11% of students

clearly understand what pathogenic bacteria that will

cause eye diseases in their hands, indicating that

many students do not understanding that germs on

the hand will spread to the eyes (eye exercises, eye

rubbing, etc.), leading to the occurrence of eye

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

418

disease.In addition, for some are not easy to use

questionnaire survey, we carried out the survey in

the form of depth interview, in the interview of the

students to reduce washing frequency and shorten

the washing time have the following reasons:

bathroom queuing, toilet environment, bathroom

facilities shabby

or no hot water, etc.In the

interview with experts, I learned that direct hand

contact with eye disease pathogens meets the eye or

the eye will improve the probability of obtaining eye

disease. Through the overall investigation, the

following situation: a considerable majority of

students do not usually pay attention to hand

hygiene, and do not do hand cleaning before eye

exercises, may be due to the not understanding of

the pathogenic bacteria caused by eye diseases.

In the preliminary descriptive statistics of the

experimental data, the hand positive rate was 10%

and the control eye was positive

The rate was as high as 65%; the hand positive

rate was 0% and the periocular positive rate was

5%.(positive criteria For> 10CFU / cm²)

Figure 1: Hand washing habits before eye exercises.

The hand flora showed hand positive rate of 10%

and 65%, hand positive rate, 0% and 5%.(Positive

label is> 10CFU/cm²)

3.2 Study Results and Analytical

Discussion

3.2.1 Analysis of the Questionnaire Results

The same score is given for hand washing before eye

exercises ("always" is 5 points and "often" is 4,

"average" is 3, "less" is 2, "never" is 1), which will

average every day. The frequency of the hand

assigns the four options in the problem to valid

numbers according to the degree size, (" 0-2 "was

set to 1," 3-5 "to 2," 6-8 "to 3, and"> 9 " to 4)

The results of the correlation of opponent

hygiene and hand washing habits before eye

exercises are shown in Table 1:

Table 1: Regression analysis of the attention of hand hygiene and the frequency of hand washing before eye exercises.

Confficents Std Error t Start P-value

Lower

95%

Upper

95%

Minimum

95%

Max

95%

Intercept 1.38394 0.30795 4.494 1.3E-05 0.77596 1.99193 0.77596 1.99193

Variable

0.22451 0.10221 2.19645 0.02271 0.02271 0.42631 0.02271 0.42631

Since the P-value of the coefficient of 0.029437

is less than the cutoff of 0.05, the regression model

is valid and has significant differences; although

Multiple R=0.17 is relatively small, the correlation

between the two. It shows that the more people who

pay attention to hand hygiene, the more they will

choose to wash their hands before eye exercises, and

it also proves to a certain extent that people who pay

attention to hand hygiene will also pay attention to

eye hygiene

The results of the understanding of eye disease

pathogens on the opponent and the correlation of

hand washing before eye exercises are shown in

Table 2.

The Correlation between Hands Hygiene before Doing Eye Exercise and Eye Diseases Diagnostic Rates

419

Table 2: Regression analysis of understanding of eye diseases and frequency of hand washing before eye exercises.

Confficents Std Error t Start P-value

Lower

95%

Upper

95%

Minimum

95%

Max

95%

Intercept 1.22865 0.29297 4.19377 4.44E-05 0.65025 1.80705 0.65025 1.80705

X Variable 0.31116 0.108201 2.87583 0.004555 0.09754 0.52478 0.097549 0.52478

Judging the P-value of the variable coefficient in

the regression found that P = 0.004 <0.05 <0.05, less

than the level of significance, is enough to prove the

effectiveness of the regression model is effective.

Even if Multiple R=0.22 is relatively small, the

positive correlation between the two variables

indicates that the higher the understanding score in

the opponent, the more attention will be paid to

washing before eye exercises. It shows that there is a

knowledge reserve of pathogenic bacteria of ey

diseases, realize the importance of eye health, will

clean the hands before eye exercises, thus reducing

the risk of hand bacteria landing around the eye, and

then re

duce the risk of eye disease.

3.2.2 Effect of Hand Washing on the Flora

of Hand Colonies

This part of the study uses the data in the

experimental test report, to facilitate data analysis,

the positive test form of "> 10" in the test report was

converted to "=10" at data input for approximate

processing. The number of colonies obtained from

the hand sampling test (in the control group before

the eye exercise) was subjected to the two-sample

heteroscedvariance test (mean t-test); variable 1 is

the number of hand colonies in the control group,

and variable 2 is the number of hand colonies in the

experimental group. By exploring the significant

difference in the seven-step number of colonies

between the two groups, it was used to determine

whether a seven-step wash could effectively clean

the hands.

The results of the two-sample heterovariance test

for the flora of colonies sampled from the control

and experimental groups are shown in Table 3.

Table 3: Two-hand heterovariance test of the effect of

hand washing on the flora of hand colonies.

variable 1

variable 2

average

8.209 2.117

variance

7.866830526 7.15372737

observed value

20 20

The mean variance

was assumed

T Stat

7.029620189

（

T<=t

）

1.12131E-08

T single-tailed critical

1.68595446

The P-value is 0.004635 <0.05, which is less

than the significance level, rejecting the original

hypothesis that the mean difference is equal to 0,

indicating that the mean between the two variables

and the mean of variable 1 is larger than variable 2,

proving that the flora of colonies before washing is

significantly higher than after washing; and also

shows that the seven-step wash method can

effectively reduce the flora of colonies.

3.2.3 Effect of the Mean Flora of Periocular

Colonies in the Hand Wash or Not

Control Group and the Experimental

Group

In this section, the positive test report of "> 10" was

approximately treated as "=10" for data analysis.

The two-sample heterovariance test of the number in

the control group (mean t-test); variable 1 is the

number of periocular colonies in the control group

and variable 2 is the number of periocular colonies

in the experimental group. By exploring whether

there were significant differences in the mean

between the two variables, we initially verified

whether the bacteria on the hand after eye exercises

caused differences in the number of periocular

bacteria (direct contact leads to bacterial transfer).

The results of the two-sample heterisovariance

test in the control and experimental groups are

shown in Table 4.

Table 4: Two-sample heterovariance test for the flora of

colonies tested in perieye samples after eye exercises

variable 1

variable 2

average

2.832 0.8415

variance

8.66392211 1.30250816

observed value

20 20

The mean variance was

assumed

T Stat

2.81792895

（

T<=t

）

0.004635

T single-tailed critical

1.70814076

The P-value was far less than 0.05, indicating

that the flora of bacteria varied significantly between

the two groups, and that the average flora of

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

420

periocular colonies in the control group was much

larger than that in the experimental group, which

partly showed that the flora of

hand bacteria in eye

exercises affected the flora of periocular bacteria.

However, considering the problem of controlling the

variables in the experiment, there may be an unequal

flora of periocular bacteria before the experiment

(the sex ratio between the experimental and control

groups was unequal, and the periocular hygiene was

inconsistent between individuals).

We further explored the above mean differences,

using cross-table analysis and chi-square test

The method to test whether hand washing is a

real opponent and perieye positive rate, to verify eye

care.Washing our hands before exercise can

effectively reduce the positive rate of our hands and

around the eyes. We will first wash our hands and

set corresponding values ("No wash" is 0 "," wash

"is 1;" Hand negative (colonies <10 CFU / cm

) is 0

and " Hand positive (colonies> 10 CFU / cm

) is 1).

In view of the difference in mean mentioned

above, cross-table analysis and chi-square test were

used to test whether hand washing had a real

opponent and periocular positive rate. The results

are shown in Table 5:

Pearson chi2（1）= 2.1053 Pr = 0.147

Table 5: Cross-table analysis of the effect of hand

washing.

wash

Hand

amount to

0 1

0 18 2 20

1 20 0 20

amount to 38 2 40

From the above chi-square analysis, the

probability P=0.147, although greater than the

above-mentioned level of 0.05, remains relative

close to 0.05, it can not explain whether the positive

rate of the opponent has a significant impact, but due

to the normal start, testing is less positive, and there

is still a greater grasp (85.3%) shows that the

positive rate of hand washing will be the opponent

It will have an impact, and hand washing can see

that hand washing reduces the positive rate. Set the

corresponding value of hand washing or not and

periocular sex (0 do not wash hands and 1; perieye

negative (colonies <10 CFU / cm2) is 0 and perieye

positive (colonies> 10CFU / cm2) = 1).

Chi-square tests of hand washing and sex of the

perieye are shown in Table 6,

Pearson chi2（1）= 15.8242 Pr= 0.000

Table 6: Chi-square test of the effect of hand washing

on the periocular positive rate.

wash

periorbital

amount to

0 1

0 7 13 20

1 19 1 20

amount to 26 14 40

P=0.000 was significantly less than 0.05,

indicating whether hand washing had a significant

effect on the perieye positive rate, and cross-tables

showed that hand washing before eye exercises can

effectively reduce the positive rate around the eye.

4 CONCLUSIONS

After research found that the vast majority of

students can not do the effective cleaning of the

opponent before the eye exercises.The main reasons

for this situation are: 1. Lack of understanding of

eye hygiene; 2. Unable to correctly grasp the hand

washing methods; 3. Restricted objective conditions,

such as low water temperature in winter, the

bathroom needs to wait. Secondly, the experiment

proved that after the seven cleaning techniques can

do hand hygiene, the hands can reach a very clean

level, at the end of the eye exercises.Later, there

were fewer bacteria around the eyes compared to the

experimental group that did not wash hands,

demonstrating that washing hands prior to eye

exercises. Reduce the number of periocular bacteria

and reduce the risk of developing bacterial eye

diseases. That is to say, to do eye exercises.Hand

washing before according to the seven-step washing

method can indeed reduce keratitis, the potential

infection rate of ophthalmitis because of the use of

seven, step-by-step washing method can ensure that

every part of the finger is cleaned, can ensure that

every part is obtained. Germicidal rather than

universal hand washing, which can lead to residual

bacteria in some parts. There are pictures that show

that the five fingers and the gaps between them are

the easiest places to forget.

Killing the bacteria will naturally reduce the

infection rate, so our assumption is naturally

true.Through second-hand data. In the literature,

there are many suggestions that the disease of

conjunctivitis and keratitis is mainly determined by

the bacteria in the hand.Because when people use

The Correlation between Hands Hygiene before Doing Eye Exercise and Eye Diseases Diagnostic Rates

421

their hands to contact the eyes are close to the eyes,

bacteria can easily enter the eye to cause disease.

Disease. There are also papers on visual eye

exercises that do not touch the eye exercises to keep

the eyes from bacteria

The infection is much better than normal eye

care, which provides theoretical evidence for our

experimental hypothesis that our control and

experimental variables of whether hand washing will

lead to conjunctivitis, and keratitis disease provides

filling. The basis of the score.Because in fact, not

allowing the hand to contact the eyes and using the

seven-step wash a good hand and then touching the

eyes is almost the same in essence, the eyes have

been protected. Physical eye exercises that do not

make contact with the eye are significantly better

than general eye care.Exercise has an advantage in

not letting bacteria enter the eye, so it can be

introduced when doing eye exercises

The degree of compound cleanliness can be

related to the potential infection rate of ophthalmitis

and keratitis.

5 DISCUSSION

Due to the lack of money and time, the group

selected volunteers from men to women was

unbalanced because the proportion was not taken

into account in the control and experimental groups.

And the volunteers' faces were not disinfected

before doing the experiment. When the experimental

nature leads to the bacteria around the second eye

extraction, it may be possible that the experimental

group already has the bacteria around the eye, thus

affecting the experimental result.This limitation is

difficult to solve, because the group cannot disinfect

the students' faces.At the same time, even if the

group has minimized the time students stay in the air

after washing their hands, the group can not fully

solve this problem without professional training,

which may lead to the experimental group, the

bacteria of the hands into the eye again. For the

experimental data, we will conduct a two-sample

mean difference t-test of the hand colony number in

the controls and the number of periocular colonies in

the control and experimental groups to explore

whether there are significant differences in the

number of colonies between the controls and around

the experimental group, respectively.If there is a

significant difference in the number of hand

colonies, the seven-step wash with hand sanitizer is

significant, but the reasons for the significant

difference in the number of periocular colonies need

to be further explored.In addition, for some are not

easy to use questionnaire survey, we carried out the

survey in the form of depth interview, in the

interview of the students to reduce washing

frequency and shorten the washing time have the

following reasons: bathroom queuing, toilet

environment, bathroom facilities shabby or no hot

water, etc.In the interview with experts, I learned

that direct hand contact with eye disease pathogens

meets the eye or the eye will improve the probability

of obtaining eye disease. Through the overall

investigation, the following situation: a considerable

majority of students do not usually pay attention to

hand hygiene, and do not do hand cleaning before

eye exercises, may be due to the not understanding

of the pathogenic bacteria caused by eye diseases.

With the rapid development of science and

technology, people use their eyes more and more

frequently. The eye is one of the important organs in

the human body. In order to ensure that the eyes of

primary and middle school students are protected,

the state has implemented eye health exercises.

However, primary and middle school students still

have a higher conjunctivitis, the prevalence of

keratitis. This study concluded that the lack of

cleanliness of the hand during eye exercises has a

relationship with ophthalmitis and the potential

infection rate of keratitis. And exactly what kind of

bacteria directly lead to ophthalmitis, keratitis

disease occurrence, will be the focus of later

research.

REFERENCES

Chen Luyao, Chen Zuyi, Huang Yuhong, Zhou you.

Study of the Effect and Field Test [B] Strait Journal of

Preventive Medicine, 2017, 2 (2)

Huang Xuelin. Scientific interpretation of hilarious eye

exercises [J] Public Health, 2013,3 (2)

Gao Rui, Li Chunwei, Liu Haiyan, Song Shaojuan, Yin

Xiaowei, Zhang Xu. Hand hygiene cognition in eye

patientsAnalysis of the status and influencing factors

[A].E-Journal of Practical Clinical Nursing, 2019,4

(43)

Gu Chengwu, Huiya, Jiang Dongping, Li Yanxia, Liang

Yuping, Zuo Shuqing. Simplify the three-step washing

method to the healthEffects of raw hand disinfection

effect [A].Modern Clinical Medicine, 2020,6,46 (3)

Li Guangxiang. Analysis of hand bacterial culture before

and after hand washing methods [J] Qilu Nursing

Journal, 2011,11,19 (2)

Li Meihong, Lei Wensheng, Ren Zhihua, Wei Lin, Xu

Liying. Two kinds of eye exercises were associated

with pediatric ocular conjunctival infection

Correlation observation [A].School Health in China,

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

422

2000,6,21 (3)

Liu Xia. How to improve the correctness of surgical hand

disinfection.[J] Public Health News, 2020,11,18 (1)

No practical eye exercises [N] Xinxiang Daily Plain

Evening News 2015,2,9

Wang Shiqin. How to effectively prevent the occurrence

of conjunctivitis [B].Medical Treatment (Second Half

Issue), 2012,10 (2)

Zhang miao. Observation of ophthalmic B-ultrasound

examination and diagnosis effect of infectious

endophthalmitis [B] Chinese Medical Guidelines,

2020,3, (1)

The Correlation between Hands Hygiene before Doing Eye Exercise and Eye Diseases Diagnostic Rates

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