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Kumari D, Kusumesh R, Sinha B, Mohan N, Asif M. Restoring the Ocular Integrity of Perforated Corneal Ulcer Using Living Surgical Donor Tissues Derived From Keratoplasty in the COVID-19 Pandemic. Cureus 2024; 16:e53607. [PMID: 38449988 PMCID: PMC10915709 DOI: 10.7759/cureus.53607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 03/08/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused an unprecedented crisis for corneal surgeons who were forced to strategize for an acute shortage of tissues. Here, we report the initial clinical outcomes of utilizing host corneal buttons derived from optical penetrating keratoplasties of pseudophakic bullous keratoplasty (PBK) patients. Two patients presented to our department with a perforated fungal corneal ulcer in one eye during the COVID-19 pandemic. One eye of each of the patients was operated on with non-vascularized host cut tissues preserved in glycerin. The tissues were secured using 10-0 nylon sutures. Good anatomical integrity was achieved in both eyes. An optical penetrating keratoplasty (PK) was done in both eyes after one year for visual rehabilitation, with a final visual acuity of 20/120 and 20/80, respectively, at six months. In conclusion, therapeutic PK using host tissues obtained from the recipients of optical PK is a safe and effective option to restore ocular integrity during a shortage of fresh or glycerol-preserved corneas. However, optical PK is required for the final visual rehabilitation.
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Affiliation(s)
- Divya Kumari
- Ophthalmology, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Patna, IND
| | - Rakhi Kusumesh
- Ophthalmology, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Patna, IND
| | - Bibhuti Sinha
- Ophthalmology, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Patna, IND
| | - Nilesh Mohan
- Ophthalmology, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Patna, IND
| | - Mohamed Asif
- Ophthalmology, Eye7 Chaudhary Eye Centre, Delhi, IND
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2
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Bonilla-Escobar FJ, Sánchez-Cano D, Lasave AF, Soria J, Franco-Cárdenas V, Reviglio VE, Dantas PEC, Palacio Pastrana C, Corbera JC, Chan RY, Diaz AL, Garcia Hernandez M, Maia M, Carpentier C, Wu L, Sanchez M, Murillo Sasamoto M, Murillo Azcárraga G, Roca JA, Serrano MA, Alezzandrini AA, Sanchez Montoya JG, Gabela G, Garcia-Aguirre G, Arevalo JF. Early-Phase Perceptions of COVID-19's Impact on Ophthalmology Practice Patterns: A Survey from the Pan-American Association of Ophthalmology. Clin Ophthalmol 2023; 17:3249-3259. [PMID: 37927574 PMCID: PMC10625333 DOI: 10.2147/opth.s434776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose The COVID-19 pandemic affected medical practice worldwide due to interventions to prevent spreading. Its effect on ophthalmology practices in Latin America has not yet been explored. We aimed to assess the perceptions about the pandemic from countries' ophthalmological national and subspecialty retina societies affiliated to the Pan-American Association of Ophthalmology (PAAO). Patients and Methods A survey-based study of leaders of national ophthalmological and retinal societies was conducted. The survey was sent by email to 30 societies, from which 20 responded (12 countries, 66.6% response rate). It included closed- and open-ended questions about (1) operational capacity and precautions, (2) telemedicine and virtual care, (3) procedures, and (4) post-pandemic considerations. Results There was a marked decline in ophthalmology patient visits (80-95%) and elective surgeries (90%) during 2020 compared to before the pandemic. Precautions like temperature checks, mask usage, and social distancing were widely implemented while personal protective equipment (PPE) availability varied. Telemedicine use was limited due to lack of experience with it. Reopening plans focused on maintaining precautions and gradually resuming activities. Economic and security concerns were raised, and adherence to guidelines was emphasized. Respondents acknowledged the need to adapt to a "new normal". Long duration drugs, fewer imaging studies, and shorter wait times were preferred; however, availability of long duration drugs was limited. Conclusion The pandemic impacted ophthalmology in Latin America, with reduced patient visits, procedures, and surgeries. Delayed treatment and complications were likely the result of the pandemic.
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Affiliation(s)
- Francisco Javier Bonilla-Escobar
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia
- Ophthalmology Department, Institute for Clinical Research Education, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Vision y Salud Ocular, VISOC, Ophthalmology Department, Universidad del Valle, Cali, Colombia
| | - Daniel Sánchez-Cano
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia
| | - Andres F Lasave
- The Retina and Vitreous Department, Private Eyes Clinic, Mar del Plata, Argentina
| | - Jaime Soria
- Ophthalmology Department, Clínica Real Visión, Uniofken, CIVE y Funcrisa, Guayaquil, Ecuador
| | | | - Victor E Reviglio
- Ophthalmology Department, Instituto de la Visión Cerro, Sanatorio Allende Cerro & Universidad Católica de Córdoba, Health Science Faculty, Cordoba, Argentina
| | - Paulo E C Dantas
- Ophthalmology Department, Sorocaba Eye Bank Hospital, Sorocaba, Brazil
| | - Claudia Palacio Pastrana
- Department of Microsurgery of the Anterior Segment, Fundación Hospital Nuestra Señora de la Luz IAP, Mexico City, Mexico
| | | | - Rita Yee Chan
- Ophthalmology Department, Clinica Nacional de Oftalmologia, Panama City, Panama
| | - Alberto Luis Diaz
- Ophthalmology Department, Complejo Medico FOSCAL Internacional, Floridablanca, Santander, Colombia
| | | | - Mauricio Maia
- Ophthalmology Department, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Cristian Carpentier
- Ophthalmology Department, Fundación Oftalmológica Los Andes, Santiago, Chile
| | - Lihteh Wu
- Retina Department, Asociados de Macula Vitreo y Retina de Costa Rica, San Jose, Costa Rica
| | - Martin Sanchez
- Ophthalmology Department, Hospital de Minas, Montevideo, Uruguay
| | | | | | - Jose A Roca
- Ophthalmology Department, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Martin A Serrano
- Retina Department, Centro Médico Docente La Trinidad, Caracas, Venezuela
| | - Arturo A Alezzandrini
- Ophthalmology Department, OFTALMOS, Universidad de Buenos Aires, Facultad de Medicina, Buenos Aires, Argentina
| | - Juan Gonzalo Sanchez Montoya
- Ophthalmology Department, Instituto Nacional de Investigacion en Oftalmologia –INIO and Clinica Oftalmologica de Antioquia, Medellin, Colombia
| | - Gregorio Gabela
- Ophthalmology Department, Hospital Metropolitano, Quito, Ecuador
| | - Gerardo Garcia-Aguirre
- Retina Department, School of Medicine, Tecnológico de Monterrey Asociación Para Evitar la Ceguera en México, Mexico City, Mexico
| | - J Fernando Arevalo
- Ophthalmology Department, Johns Hopkins University, Wilmer Eye Institute, Baltimore, MD, USA
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Mousavi M, Kahuam-López N, Iovieno A, Yeung SN. Global impact of COVID-19 on corneal donor tissue harvesting and corneal transplantation. Front Med (Lausanne) 2023; 10:1210293. [PMID: 37608828 PMCID: PMC10440952 DOI: 10.3389/fmed.2023.1210293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
Introduction The purpose of this review is to consolidate and examine the available literature on the coronavirus disease 2019 pandemic and its effect on corneal transplantation and eye banking. Methods A primary literature search was conducted using the PubMed (Medline) database with keywords and MeSH terms such as "corneal transplantation," "eye banks," "keratoplasty" and then were combined with COVID-19. Relevant articles through September 2022 were assessed and 25 articles were included in this review. Results Donor tissue volumes declined globally during lockdown periods due to a lower number of referrals and tighter tissue screening guidelines. Rates of elective surgeries decreased in the lockdown period compared to respective periods in previous years. However, changes in rates of emergency procedures were not uniform across different regions. Moreover, rates of different elective corneal grafts [i.e., penetrating keratoplasty (PK), endothelial keratoplasty (EK), or anterior lamellar keratoplasty (ALK)] were affected differently with the pattern of change being dependent on region-specific factors. Conclusion Both donor tissue volumes and rates of corneal transplant procedures were affected by lockdown restrictions. The underlying etiology of these changes differed by region. Examining the range of impact across many countries as well as the contributing factors involved will provide guidance for future global pandemics.
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Affiliation(s)
| | | | | | - Sonia N. Yeung
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
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Beckman JJ, Webster CR, Richardson C, Fullmer M, Kendall E, Hazariwala V, Bondira I, Nguyen B, Gao M, Speicher M, Aggarwal H. A cross-sectional study of the impact of the COVID-19 pandemic on an ophthalmology consult service in four Michigan community hospitals. Indian J Ophthalmol 2023; 71:2856-2861. [PMID: 37417134 PMCID: PMC10491085 DOI: 10.4103/ijo.ijo_82_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/13/2023] [Accepted: 03/27/2023] [Indexed: 07/08/2023] Open
Abstract
Purpose During the coronavirus disease 2019 (COVID-19) pandemic, private practice, inpatient consult services, and academic residency programs in ophthalmology saw a decrease in patient encounters. This study elucidates how community hospital ophthalmology consult (OC) services were affected during the pandemic. We aim to determine whether there was a change in resident OC volume in a community-based ophthalmology program consult service during the COVID-19 pandemic. Secondary objectives included analyzing the change in the types of diagnoses and the number of patients seen for diabetic retinopathy over the same time. Methods A retrospective cross-sectional study was conducted reviewing the electronic health record (EHR) charts from OCs for the period 2017-2021. Records were categorized by referral source and the nature of OCs (trauma, acute, or chronic); OCs were further grouped by year and weak of referral. An intermonth analysis of weekly OC counts in each category was performed for the average number of consults in February-April 2017-2019 and for February-April 2020. A one-tailed t-test was performed. All t-tests assumed equal variances. Results Weekly OCs in 2020 revealed no statistically significant differences in overall cases or in acute or chronic cases when the volume before the COVID-19 pandemic was compared to the volume after the onset of the pandemic. However, a statistically significant increase in the average weekly trauma cases was noted when 2020 (an average of 2.7 cases per week) was compared to the weekly average for the same weeks of years 2017- 2019 (0.4; P = 0.016). This statistically significant increase in trauma in 2020 disappeared when comparing weeks 11-17 in 2020 (2.2 cases per week) and the average of 2017-2019 (1.1). Conclusion This report outlines no significant change in OCs before and after the onset of the pandemic compared to three previous years. There was, however, an increase in trauma consults during the pandemic and an increase in the number (though not the proportion) of diabetic retinopathy (DR+) patients seen by residents. This report uniquely describes no significant changes in the resident volume of patients seen during the COVID-19 global pandemic.
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Affiliation(s)
- Jamie J Beckman
- Taylor Ophthalmology Residency Program, Beaumont Hospital, Dearborn MI, United States
| | - Court R Webster
- Department of Neuro- Ophthalmology, Michigan State University, East Lansing, MI, United States
| | - Cole Richardson
- Taylor Ophthalmology Residency Program, Beaumont Hospital, Dearborn MI, United States
| | - Matthew Fullmer
- Taylor Ophthalmology Residency Program, Beaumont Hospital, Dearborn MI, United States
| | - Emerson Kendall
- Taylor Ophthalmology Residency Program, Beaumont Hospital, Dearborn MI, United States
| | - Vikisha Hazariwala
- Taylor Ophthalmology Residency Program, Beaumont Hospital, Dearborn MI, United States
| | - Inna Bondira
- Taylor Ophthalmology Residency Program, Beaumont Hospital, Dearborn MI, United States
| | - Brian Nguyen
- Taylor Ophthalmology Residency Program, Beaumont Hospital, Dearborn MI, United States
| | - Mary Gao
- Taylor Ophthalmology Residency Program, Beaumont Hospital, Dearborn MI, United States
| | - Mark Speicher
- American Association of Colleges of Osteopathic Medicine, Bethesda, MD, United States
| | - Himanshu Aggarwal
- Taylor Ophthalmology Residency Program, Beaumont Hospital, Dearborn MI, United States
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5
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H Fortes B, D Tailor P, T Xu T, A Churchill R, R Starr M. Clinical Characteristics and Outcomes of Endophthalmitis Before and During the COVID-19 Pandemic. J Ophthalmic Vis Res 2023; 18:289-296. [PMID: 37600921 PMCID: PMC10432927 DOI: 10.18502/jovr.v18i3.13777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/12/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose To evaluate the clinical characteristics and visual acuity outcomes of patients who presented with endophthalmitis prior to and during the coronavirus disease 2019 (COVID-19) pandemic. Methods This multicenter retrospective case series with historical controls included consecutive patients presenting with any form of endophthalmitis from March 1, 2019 to September 1, 2019 (pre-COVID-19) and from March 1, 2020 to September 1, 2020 (COVID-19) at Mayo Clinic Rochester (MCR), Health System (MCHS), Arizona (MCA), and Florida (MCF) sites. Cases were divided into "pre-COVID-19" versus "COVID-19" groups depending on when they first presented with endophthalmitis. Results Twenty-eight cases of endophthalmitis presented to all Mayo Clinic sites during the study period. Of these, 10 patients presented during the first six months of the COVID-19 pandemic. During the same six-month period the year prior, 18 patients presented with endophthalmitis. Endophthalmitis etiology (post-injection, post-cataract extraction, post-glaucoma filtering surgery, post-pars plana vitrectomy, endogenous, and others) was similar between both groups (P = 0.34), as was post-injection endophthalmitis rate (P = 0.69), days to presentation (P = 0.07), initial management (P = 0.11), culture-positivity rate (P = 0.70), and need for subsequent pars plana vitrectomy (P = 1). Visual acuity outcomes were similar between both groups at six months, however, the mean LogMAR visual acuity at presentation was worse in the COVID-19 group compared to the pre-COVID-19 group (2.44 vs 1.82; P = 0.026). Conclusion Clinical characteristics and the post-injection endophthalmitis rate were similar during both periods, however, patients presented with worse vision during the pandemic suggesting that the pandemic may have contributed to delayed presentation, regardless, outcomes are still poor.
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Affiliation(s)
- Blake H Fortes
- Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Prashant D Tailor
- Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Timothy T Xu
- Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN, USA
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Kapoor M, Nidhi Kaur K, Saeed S, Shannawaz M, Chandra A. Impact of COVID-19 on healthcare system in India: A systematic review. J Public Health Res 2023; 12:22799036231186349. [PMID: 37461400 PMCID: PMC10345816 DOI: 10.1177/22799036231186349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 06/17/2023] [Indexed: 07/20/2023] Open
Abstract
Despite an extensive healthcare system in India, the COVID-19 Pandemic created havoc upon the existing Indian healthcare system by disrupting the supply of essential healthcare services to patients. It has also highlighted the significant-quality discrepancies of healthcare facilities between the rural-urban areas and between public and private healthcare providers. The not so advanced healthcare system of India was exposed through the lack of oxygen and essential drugs required for the treatment of COVID-19. Additionally, during the pandemic period there was a drastic decline in seeking non-COVID-19 disease related healthcare services. The objective of this systematic review is to determine whether COVID-19 has impacted the healthcare system in India.
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Affiliation(s)
- Megha Kapoor
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
| | - Karuna Nidhi Kaur
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
| | - Shazina Saeed
- Amity Institute of Public Health, Amity University, Uttar Pradesh, Noida, India
| | - Mohd Shannawaz
- Amity Institute of Public Health, Amity University, Uttar Pradesh, Noida, India
| | - Amrish Chandra
- Amity Institute of Public Health, Amity University, Uttar Pradesh, Noida, India
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Madkaiker A, Venugopal A, Ghorpade A, Ravindran M, Ragappa R, Sithiq MU. Eye banking and keratoplasty trend analysis during the COVID-19 pandemic: A South Indian observational study. Indian J Ophthalmol 2023; 71:498-502. [PMID: 36727346 PMCID: PMC10228964 DOI: 10.4103/ijo.ijo_1368_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/26/2022] [Accepted: 11/09/2022] [Indexed: 02/03/2023] Open
Abstract
Purpose To analyze the impact on eye donation and corneal transplantation during the COVID-19 pandemic in a tertiary eye hospital in south India. Methods A retrospective analysis of the donor and recipient records during the study period from January 2020 to May 2021 was conducted and tabulated in Microsoft Excel 2013. Demographic details of the donor, utility rate, cause of death, culture characteristics, storage methods, wet lab usage, and the surgical donor outcomes were evaluated. Additionally, the postoperative workup of the recipients, diagnosis, graft infection and rejection episodes, development of COVID-19 postoperatively, and outcome in terms of visual acuity at one, three, and six months were also noted. Results A total of 466 eyes from 249 donors were received during the study period. The mean age of the donor population was 62.43 years (20.9). The corneal transplantation utility rate was 36.4% (n = 170). Fifty-one percent of the total transplant surgeries were for therapeutic purposes. This was followed by penetrating optical keratoplasty (34%), Descemet's stripping endothelial keratoplasty (9%), and patch grafts (3%). Seventeen (10%) graft rejection episodes were noted and nine (53%) had complete resolution after medical treatment. Conclusion Proper preventive measures are key to carrying out safe and efficient eye banking activities even during a deadly pandemic, as COVID-19 transmission via transplantation is rare.
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Affiliation(s)
- Aditee Madkaiker
- Medical Officer, Cornea and Refractive Services, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
| | - Anitha Venugopal
- HOD and Professor, Cornea and Refractive Services, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
| | - Aditya Ghorpade
- Consultant, Cornea and Refractive Services, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
| | - Meenakshi Ravindran
- HOD and Professor, Pediatrics and Strabismology Services, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
| | - Ramakrishnan Ragappa
- Advisor and Professor, Glaucoma Services, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
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Kandiah T, Li X, MacMillan Y, Malvankar-Mehta MS. Access to Pediatric Eye Care During a Pandemic: Systematic Review and Meta-Analysis. Pediatr Ann 2023; 52:e68-e75. [PMID: 36779881 DOI: 10.3928/19382359-20230130-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Visual impairment affects many children and can lead to blindness if untreated. The coronavirus disease 2019 (COVID-19) pandemic has led to various restrictions and other challenges accessing in-person medical care, including essential pediatric eye care. The aim of this article was to determine and quantify the effect that pandemics have on access to pediatric eye care. A systematic literature search was conducted using various databases, which yielded 257 articles; nine were included in the final review. All included studies reported a decrease in the number of children accessing eye care during COVID-19. Most studies described virtual triage systems, which restricted in-person care to emergent cases. The average decrease in daily pediatric visits was 67.32% and reached statistical significance in the meta-analysis (P < .01). However, out of all patients with ocular complaints, the proportion of pediatric visits was unchanged, suggesting that the decrease in access to eye care was not specific to pediatric patients. [Pediatr Ann. 2023;52(2):e68-e75.].
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Paliwal M, Raj R, Kumar V, Singh S, Sharma NK, Suri A, Kumari M. Informal workers in India as an economic shock absorber in the era of COVID-19: A study on policies and practices. HUMAN SYSTEMS MANAGEMENT 2023. [DOI: 10.3233/hsm-220155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND: With greater uncertainties and economic divides in Indian formal and Informal economies; the lockdown in its unprecedented ways severely knocked the crucial vulnerabilities of majorly the informal sector of the economy. METHODS: The study was conducted across the Indian population who have suffered from the bad impact of COVID-19 and the lockdown. The data collection process was conducted during the COVID-19 outbreak from June 2020 to October 2020. Multiple regression analysis and independent-sample t-test were applied to test the hypothesis. RESULTS: The study closely highlights the role of the government system towards non-government organizations those who played a crucial role in the welfare of the informal workers. The results suggest that the most affected group of people in the COVID-19 lockdown are the informal workers who were working on daily wages for their bread and butter. The government endeavor was also found significant in supporting the informal workers.
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Affiliation(s)
- Minakshi Paliwal
- Department of Commerce, Daulat Ram College, University of Delhi, Delhi, India
| | - Rohit Raj
- Department of Information Management, Chaoyang University of Technology, Taichung, Taiwan
| | - Vimal Kumar
- Department of Information Management, Chaoyang University of Technology, Taichung, Taiwan
| | - Sumanjeet Singh
- Department of Commerce, Ramjas College, University of Delhi, New Delhi, India
| | | | - Alka Suri
- Department of Economics, D.B.S. College, Deharadun, Uttrakhand, India
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Shahid E, Fasih U, Taqi U, Jafri AR. An unusual rise in cases of assault in ophthalmic practice during COVID-19 lockdown in a tertiary care hospital. Oman J Ophthalmol 2022; 15:309-314. [PMID: 36760946 PMCID: PMC9905921 DOI: 10.4103/ojo.ojo_323_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/30/2022] [Accepted: 04/09/2022] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE The objective of the study is to report an unusual rise in cases of assault with ocular injury and their medicolegal implications presenting in an eye department of a tertiary care hospital during COVID-19 lockdown. MATERIALS AND METHODS A retrospective, observational case series was conducted in the Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi. Data were retrieved from the medicolegal records of the patients from April 1, 2019, to July 31, 2019, and similar months in 2020. We included all the patients of assault with ocular injury as alleged, registered as medicolegal cases. Patients with accidental injuries were excluded from the study. RESULTS There was 34.3% increase in cases of assault with ocular injury as alleged with 72.35% reduction in the outpatient department patients. The ratio of cases of assault in 2019 and 2020 is 1:4.62. The mean age of the patients in the lockdown year was 33.74 ± 11.9 standard deviation (SD) and in preCOVID year 2019 was 39.74 ± 15.9 SD. Blunt trauma was experienced by 57 (66.3%) and penetrating injury in 2 (2.3%) patients. Sixteen (18.6%) patients had no ocular involvement. Home was the place of assault in 32 (37.2%) and street in 27 (31.4%) individuals. Fist was the source of assault in 46 (53.3%) and rod or stick in 15 (17.4%) individuals. CONCLUSION There is a fourfold increase in patients of assault during 4 months of COVID-19 lockdown in 2020 as compared to the same time period in 2019. Most of these patients were young age, male gender, and uneducated. The most common place of incident was home, and fist was the most common source of infliction. Most of the injuries were superficial and had minimum effect on visual acuity.
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Affiliation(s)
- Erum Shahid
- Department of Ophthalmology, Karachi Medical and Dental College, Abbasi Shaheed Hospital, Karachi, Pakistan,Address for correspondence: Dr. Erum Shahid, C 88, Block A, North Nazimabad, Karachi, Pakistan. E-mail:
| | - Uzma Fasih
- Department of Ophthalmology, Karachi Medical and Dental College, Abbasi Shaheed Hospital, Karachi, Pakistan
| | - Uzma Taqi
- Department of Ophthalmology, Baqai Medical University, Karachi, Pakistan
| | - Asad Raza Jafri
- Department of Ophthalmology, Karachi Medical and Dental College, Spencer Eye Hospital, Karachi, Pakistan
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The Impact of the COVID-19 Pandemic on Ophthalmic Outpatient Care in a Tertiary Care Center in Riyadh. Healthcare (Basel) 2022; 10:healthcare10091654. [PMID: 36141265 PMCID: PMC9498299 DOI: 10.3390/healthcare10091654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/27/2022] [Accepted: 08/28/2022] [Indexed: 01/18/2023] Open
Abstract
In this paper, we measured the impact of a full COVID-19 lockdown on ophthalmic patients after a period of lockdown in Saudi Arabia, from March to September 2020. A cross-sectional analytical study was carried out on 180 patients who had their appointments delayed or canceled due to the lockdown. Data was collected from electronic medical records and patients via voice calls using a validated questionnaire that were analyzed using a multivariable binary regression analysis. The results show no statistically significant mean difference in visual acuity when comparing pre- and post-lockdown measurements. The median number of appointment cancellations/delays per patient was two, and the estimated delay for the first canceled appointments was equal to 178.8 days. Of the cohort studied, 15.4% of patients faced delays in necessary surgical and therapeutic interventions; 22.1% of patients sought eye care at other institutions due to the delay, and 15% of those were seen by doctors unspecialized in ophthalmology. The odds of dissatisfaction with care were higher in patients who experienced cancellations in a surgical procedure and patients who experienced difficulty in obtaining medications. In conclusion, the pandemic hampered ophthalmic patients’ access to medications. Subjective visual outcomes of patients were also negatively affected; however, the change in objective visual parameters was not statistically significant.
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Lau VI, Dhanoa S, Cheema H, Lewis K, Geeraert P, Lu D, Merrick B, Vander Leek A, Sebastianski M, Kula B, Chaudhuri D, Agarwal A, Niven DJ, Fiest KM, Stelfox HT, Zuege DJ, Rewa OG, Bagshaw SM. Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES): A systematic review and meta-analysis. PLoS One 2022; 17:e0269871. [PMID: 35749400 PMCID: PMC9231780 DOI: 10.1371/journal.pone.0269871] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/29/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND As the Coronavirus Disease-2019 (COVID-19) pandemic continues, healthcare providers struggle to manage both COVID-19 and non-COVID patients while still providing high-quality care. We conducted a systematic review/meta-analysis to describe the effects of the COVID-19 pandemic on patients with non-COVID illness and on healthcare systems compared to non-pandemic epochs. METHODS We searched Ovid MEDLINE/EMBASE/Cochrane Database of Systematic Reviews/CENTRAL/CINAHL (inception to December 31, 2020). All study types with COVID-pandemic time period (after December 31, 2019) with comparative non-pandemic time periods (prior to December 31, 2019). Data regarding study characteristics/case-mix/interventions/comparators/ outcomes (primary: mortality; secondary: morbidity/hospitalizations/disruptions-to-care. Paired reviewers conducted screening and abstraction, with conflicts resolved by discussion. Effect sizes for specific therapies were pooled using random-effects models. Risk of bias was assessed by Newcastle-Ottawa Scale, with evidence rating using GRADE methodology. RESULTS Of 11,581 citations, 167 studies met eligibility. Our meta-analysis showed an increased mortality of 16% during the COVID pandemic for non-COVID illness compared with 11% mortality during the pre-pandemic period (RR 1.38, 95% CI: 1.28-1.50; absolute risk difference: 5% [95% CI: 4-6%], p<0.00001, very low certainty evidence). Twenty-eight studies (17%) reported significant changes in morbidity (where 93% reported increases), while 30 studies (18%) reported no significant change (very low certainty). Thirty-nine studies (23%) reported significant changes in hospitalizations (97% reporting decreases), while 111 studies (66%) reported no significant change (very low certainty). Sixty-two studies (37%) reported significant disruptions in standards-to-care (73% reporting increases), while 62 studies (37%) reported no significant change (very low certainty). CONCLUSIONS There was a significant increase in mortality during the COVID pandemic compared to pre-pandemic times for non-COVID illnesses. When significant changes were reported, there was increased morbidity, decreased hospitalizations and increased disruptions in standards-of-care. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020201256 (Sept 2, 2020).
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Affiliation(s)
- Vincent Issac Lau
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Sumeet Dhanoa
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Harleen Cheema
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Kimberley Lewis
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Critical Care Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Patrick Geeraert
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - David Lu
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Benjamin Merrick
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Aaron Vander Leek
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Meghan Sebastianski
- Alberta Strategy for Patient-Orientated Research Knowledge Translation Platform, University of Alberta, Edmonton, Alberta, Canada
| | - Brittany Kula
- Division of Infectious Disease, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Dipayan Chaudhuri
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Critical Care Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Arnav Agarwal
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, General Internal Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Daniel J Niven
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Danny J Zuege
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Oleksa G Rewa
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sean M Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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13
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Marchenko NR, Kasparova EA, Budnikova EA, Makarova MA. [Anterior eye segment damage in coronavirus infection (COVID-19)]. Vestn Oftalmol 2021; 137:142-148. [PMID: 34965080 DOI: 10.17116/oftalma2021137061142] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Conjunctivitis may appear as the first symptom of the coronavirus infection (COVID-19). In isolated cases, the lesion of the conjunctiva evokes a systemic infectious process. Currently, the conjunctiva is not considered as an area of long-term reproduction of coronavirus, and its damage is caused by hyperproduction of pro-inflammatory cytokines (especially IL-6); development of iridocyclitis and keratoconjunctivitis is also possible. Most often, local corticosteroids are used to treat these processes, although their use requires caution due to the risk of activating secondary infection (herpetic bacterial, fungal), which often develops as a result of immunodeficiency caused both by COVID-19 and the massive corticosteroid and antibiotic therapy employed when the course of the disease is severe. The severe condition of patients, the lung ventilation, and the prone position all contribute to corneal erosions, exposure keratopathy, pseudomonas aeruginosa keratitis and angle-closure glaucoma attacks. The risk of transmission of coronavirus infection during keratoplasty is estimated as minimal.
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Affiliation(s)
| | | | | | - M A Makarova
- Research Institute of Eye Diseases, Moscow, Russia
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14
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Das AV, Dave VP. Effect of Lockdown and Unlock Following COVID-19 on the Presentation of Patients With Endophthalmitis at a Tertiary Eye Center Over One Year. Cureus 2021; 13:e19469. [PMID: 34912611 PMCID: PMC8665696 DOI: 10.7759/cureus.19469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction Endophthalmitis is an emergency where patients need immediate intervention to salvage both vision and the globe. Regular follow-up care and close monitoring of the status of the patient are crucial in determining the final outcomes of the treatment. While there is ample literature on the epidemiology and demography of endophthalmitis across the globe, no information exists on the effect of the coronavirus disease 2019 (COVID-19) pandemic on the presentation patterns of endophthalmitis. Objectives To describe the impact of the lockdown and unlock phases of the COVID-19 pandemic on the presentation of endophthalmitis at a tertiary eye care center in India. Methods This cross-sectional hospital-based study included 1,253 patients presenting between March 25, 2017, and March 31, 2021. The data on the patients diagnosed with endophthalmitis in one or both eyes presenting during the lockdown and unlock phases were compared with the respective time periods in the previous three years before COVID-19. Results The patient numbers dropped to 42.18% (27/64) of pre-COVID-19 volumes during the lockdown phase. There was a near-complete recovery of the outpatient numbers to 85.71% (26/30) of pre-COVID-19 volumes by March 2021. This gradual incremental trend was seen in etiology due to post-surgery (88%) and endogenous (159%) infections while post-traumatic (67%) and post-infection (0%) infections were lower than pre-COVID-19 volumes by March 2021. There was a slight increase in the proportion of patients with acute endophthalmitis (88.93% vs 86.20%; p=0.76) presenting during the COVID-19 phase as compared to the pre-COVID-19 phase. The proportion of patients requiring inter-state travel showed complete recovery to 107% of pre-COVID-19 distribution by March 2021. Conclusion The first year of the COVID-19 pandemic saw a decline of over half the number of patients with endophthalmitis accessing eye care services. There was an increase in the presentation of endogenous endophthalmitis and a decrease in post-traumatic forms. Patients requiring inter-state travel recovered during the unlock phase.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart Electronic Medical Record (EMR) & AEye, Indian Health Outcomes, Public Health and Economics Research Center, L V Prasad Eye Institute, Hyderabad, IND
| | - Vivek Pravin Dave
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, The Retina Institute, LV Prasad Eye Institute, Hyderabad, IND
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15
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Maalej R, Hage R, Salviat F, Vignal-Clermont C. Impact of lockdown during the COVID-19 outbreak on ophthalmological emergencies in a referral center in France. J Fr Ophtalmol 2021; 45:1-8. [PMID: 34823891 PMCID: PMC9304632 DOI: 10.1016/j.jfo.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022]
Abstract
Purpose In March 2020, the sudden rise in the number of SARS-CoV-2 infections in France led the government to impose a strict lockdown during which all non-urgent medical consultations were postponed. From March 17 to May 10, 2020, private medical practices were closed, and telemedicine was encouraged. The consequences on ophthalmic care were dramatic, with over 90% of scheduled consultations canceled. The goal of this study was to describe consultations during the 2-month strict lockdown in Paris and to analyze its impact on the visual outcomes of patients consulting in the ophthalmology emergency department (OED). Methods Data of patients who presented to the OED of the A. de Rothschild Foundation Hospital (RFH), a tertiary ophthalmology center in Paris, France, during the lockdown period and its immediate aftermath were analyzed. The results were compared to the same time periods in the years 2018 and 2019. Four time periods were defined and numbered chronologically: March 17 to May 10, 2018 (period 1); March 17 to May 10, 2019 (period 2); March 17 to May 10, 2020 (period 3, the lockdown period); May 11 to June 9, 2020 (period 4, the post-lockdown period). Results The number of consultations was reduced by more than 50% during the lockdown period (n = 2909 patients) and by 30% during the post-lockdown period (n = 2622) when compared to periods 1 (n = 7125) and 2 (n = 8058). Even though LP4 saw an increase in the number of patients consulting, there was no increase in the rate of severe diseases (12.8% during LP3 vs. 11.1% during LP4), and the proportion of patients who were admitted was statistically similar (4.3% vs. 3.6%). Neuro-ophthalmic diseases were the most common during LP3 and LP4. Neovascular glaucoma was twice as common during post-LP4 (P = 0.08). We noted a significant increase in patients with graft rejection consulting in our OED during the post-LP4 (P < 0.001). These results were likely related to a delay in follow-up consultations due to the lockdown measures. Conclusion The reduction in the number of consultations in our OED during the lockdown period affected both minor emergencies and severe ophthalmic diseases, but with no significant delay in diagnosis. More longitudinal and longer study is needed to confirm this and to retrospectively analyze the effects of the COVID-19 outbreak and lockdown.
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Affiliation(s)
- R Maalej
- Neuro-ophthalmology and Emergency department, Hôpital Fondation Rothschild, Paris, France.
| | - R Hage
- Neuro-ophthalmology and Emergency department, Hôpital Fondation Rothschild, Paris, France
| | - F Salviat
- Department of clinical research, Hôpital Fondation Rothschild, Paris, France
| | - C Vignal-Clermont
- Neuro-ophthalmology and Emergency department, Hôpital Fondation Rothschild, Paris, France
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16
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Butt GF, Recchioni A, Moussa G, Hodson J, Wallace GR, Murray PI, Rauz S. The impact of the COVID-19 pandemic on microbial keratitis presentation patterns. PLoS One 2021; 16:e0256240. [PMID: 34407118 PMCID: PMC8372897 DOI: 10.1371/journal.pone.0256240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Microbial keratitis (MK) is the most common non-surgical ophthalmic emergency, and can rapidly progress, causing irreversible sight-loss. This study explored whether the COVID-19 (C19) national lockdown impacted upon the clinical presentation and outcomes of MK at a UK tertiary-care centre. METHODS Medical records were retrospectively reviewed for all patients with presumed MK requiring corneal scrapes, presenting between 23rd March and 30th June in 2020 (Y2020), and the equivalent time windows in 2017, 2018 and 2019 (pre-C19). RESULTS In total, 181 and 49 patients presented during the pre-C19 and Y2020 periods, respectively. In Y2020, concurrent ocular trauma (16.3% vs. 5.5%, p = 0.030) and immunosuppression use (12.2% vs 1.7%, p = 0.004) were more prevalent. Despite proportionately fewer ward admissions during the pandemic (8.2% vs 32.6%, p<0.001), no differences were observed in baseline demographics; presenting visual acuity (VA; median 0.6 vs 0.6 LogMAR, p = 0.785); ulcer area (4.0 vs 3.0mm2, p = 0.520); or final VA (0.30 vs 0.30 LogMAR, p = 0.990). Whilst the overall rates of culture positivity were similar in Y2020 and pre-C19 (49.0% vs. 54.7%, p = 0.520), there were differences in the cultures isolated, with a lower rate of poly-microbial cultures in Y2020 (8.3% vs. 31.3%, p = 0.022). CONCLUSIONS Patient characteristics, MK severity and final visual outcomes did not appear to be affected in the first UK lockdown, despite fewer patients being admitted for care. Concurrent trauma and systemic immunosuppression use were greater than in previous years. The difference in spectra of isolated organisms may relate to behavioural changes, such as increased hand hygiene.
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Affiliation(s)
- Gibran F. Butt
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- Birmingham & Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
| | - Alberto Recchioni
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- Birmingham & Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
| | - George Moussa
- Birmingham & Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
| | - James Hodson
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Graham R. Wallace
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Philip I. Murray
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- Birmingham & Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
| | - Saaeha Rauz
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- Birmingham & Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
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17
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Shimels T. The Trend of Health Service Utilization and Challenges Faced During the COVID-19 Pandemic at Primary Units in Addis Ababa: A Mixed-Methods Study. Health Serv Res Manag Epidemiol 2021; 8:23333928211031119. [PMID: 34291123 PMCID: PMC8273870 DOI: 10.1177/23333928211031119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 12/22/2022] Open
Abstract
Introduction The COVID-19 pandemic has imposed an extraordinary challenge to the health and socio-economic facet of nations globally. Health facilities have encountered tremendous challenges to contain service delivery at all levels. This study aims to assess the trend of health service utilization and challenges faced during the COVID-19 pandemic at primary units in Addis Ababa, Ethiopia. Method A multi-facility-based cross-sectional study was conducted in Addis Ababa between 1 and 30 of August 2020. A mixed-methods design was employed, and both quantitative and qualitative data were collected at 5 health centers. Facilities were selected randomly from 5 sub-cities while interviewees were recruited purposively. A structured questionnaire was used to collect quantitative data from the HMIS units of each facility. Qualitative data was collected using a semi-structured key-informant interview guide. Quantitative data were analyzed using Microsoft Excel, and a 10-month time-series trend was generated. For the qualitative data, qualitative data analysis (QDA-minor) software was used. Results Time-series comparison of the pre-COVID-19 era loads with the COVID-19 period showed that there was an extensive disparity in the service delivery capacity of the health facilities. A huge drop in inpatient flow of some units such as PICT, VCT, FP services, and most sub-units of the OPDs has been recorded following the COVID-19 outbreak. The key-informant interview also revealed that such challenges, as fear of infection and stigma, poor infrastructure, challenges related to human resources, and challenges related to the supply of prevention and treatment inputs were prominently encountered at the health centers. Conclusion The COVID-19 wave has negatively impacted many service delivery points in the study settings. The presence of weak infrastructure, lack of PPEs, fear of the infection and stigma, and staff workload have been mentioned as the predominant challenges faced during the outbreak. Health authorities should arrange multifaceted supports to ensure uninterrupted service delivery at primary healthcare units.
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Affiliation(s)
- Tariku Shimels
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia, Africa
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18
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Joshi P, Bhat S, Balasubramaniam A. Impact of COVID-19 pandemic on patients with corneal transplant. Indian J Ophthalmol 2021; 69:1967-1968. [PMID: 34146075 PMCID: PMC8374772 DOI: 10.4103/ijo.ijo_651_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Pallavi Joshi
- Department of Cornea, Ocular Surface and Refractive Services, Bangalore, Karnataka, India
| | - Shruti Bhat
- Department of Cornea and Refractive Services, Sankara Eye Hospital, Bangalore, Karnataka, India
| | - Anand Balasubramaniam
- Department of Cornea and Refractive Services, Sankara Eye Hospital, Bangalore, Karnataka, India
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19
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Letter to the Editor: Glaucoma Surgery During the COVID-19 Pandemic in Italy: How Novel Coronavirus Has Changed the Surgical Management of Glaucoma Patients. J Glaucoma 2021; 30:e187-e188. [PMID: 33596012 DOI: 10.1097/ijg.0000000000001810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Rehman O, Ichhpujani P, Nayyar S, Kumar S. COVID-19 pandemic and lockdown: Changing trends in Ophthalmology for in-patient and emergency services. Indian J Ophthalmol 2021; 69:701-705. [PMID: 33595504 PMCID: PMC7942100 DOI: 10.4103/ijo.ijo_3009_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the changing trends in terms of patient load, presenting complaints, surgical procedures and resource utilization in a multispeciality tertiary care hospital after lockdown due to COVID-19. Methods: Retrospective data were collected from Ophthalmology in-patient and emergency services of a government medical college and multispecialty tertiary care hospital in North India. Data pertaining to patient census, presenting complaints, surgical procedures and resource consumption were compared in the 6-month period (March 25 to September 30, 2020) following national lockdown and subsequent gradual unlock to data of same time period last year. Results: A total of 1152 new patients visited Ophthalmology emergency service, whereas 324 sought tele-ophthalmology consultation. Majority were males (61.8%, n = 712), whereas average age of presentation was 34 ± 7.2 years. The number of patients seeking emergency ophthalmic care reduced by 23.9% in the current year, in-patient record reduced by 96.53% and number of surgeries reduced by 98.13%. Tele-ophthalmology services comprised 21.95% of the total patient load. Use of triple layered surgical masks increased by 85.7%, use of disposable gloves increased by 89.5% but interestingly the availability of chlorhexidine hand rub fell by 15.9%, in the current year compared to last year. Conclusion: COVID-19 pandemic and lockdown have reduced the number of patients visiting tertiary health care facility for ophthalmic care. As manpower and resource consumption has increased, smart management is needed to tackle the current scenario efficiently. Tele-ophthalmology must be promoted and we must understand the changing trends to plan for the future accordingly.
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Affiliation(s)
- Obaidur Rehman
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Parul Ichhpujani
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Shifali Nayyar
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Suresh Kumar
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
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