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Karhanová M, Cyžová Z, Schreiberová Z, Kalitová J, Mlčák P, Kalábová S, Mlčáková E, Marešová K. The Impact of the COVID-19 Pandemic on the Quality of Examination in Eye Clinics in the Czech Republic - Questionnaire Study. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2024; 80:103-113. [PMID: 38531683 DOI: 10.31348/2024/15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
PURPOSE The aim of the study was to map the behavior of ophthalmologists regarding protective equipment during the COVID-19 pandemic (coronavirus disease 2019), both during the time of the mandatory restrictive measures and after their relaxation. Another aim was to evaluate the awareness of ophthalmologists in the Czech Republic about the possible impact of nose and mouth protective measures (masks, respirators) on the quality of eye examinations, especially on the results of standard automated perimetry (SAP) and intraocular pressure (IOP) measurement. MATERIALS AND METHODS As part of two professional ophthalmological events in the Czech Republic, which took place in 2022, we obtained and evaluated data from the ophthalmologists in attendance using a questionnaire. We evaluated demographic parameters, frequency of use and type of nose and mouth protective equipment and their influence on the quality of ophthalmological examination as well as the awareness of ophthalmologists about their possible influence on the outcome of SAP and IOP measurements. RESULTS We obtained data from a total of 212 respondents (148 women, 44 men, in 20 cases gender was not stated). In 91.5% of cases, ophthalmologists agreed that the use of respirators and masks makes ophthalmological examination more difficult. The most common problems were eyepiece fogging (85.8%), examination lens fogging (85.8%), and lens fogging when spectacles correction was prescribed (79.2%). The respondents most often combated these problems either by completely removing the respirator (24.1%) or at least by pulling it under the nose (39.2%). At the time when the measures were relaxed, significantly more men did not use any nose and mouth protection at all during ophthalmological examinations (15.8% of men vs. 4.2% of women; p = 0.032). An alarming finding was the fact that 35.6% of respondents did not know whatsoever whether the nurse was performing a perimetry examination on a patient with a respirator/mask or without protective equipment, i.e. they were not aware whatsoever of the possible formation of artifacts. Only 21.2% of respondents were aware of the possible difficulties of measuring IOP while wearing a respirator, while 59.9% of respondents were not aware of this risk (39.6% had never considered this problem, 20.3% of respondents were convinced that a respirator could not have an effect on the measurement of IOP). CONCLUSION The use of nose and mouth protective equipment clearly affects the ophthalmological examination and makes it more difficult. Although ophthalmologists belong to a group at high risk for the possible transmission of infection in the performance of their profession, they often removed nose and mouth protection in an effort to eliminate fogging of eyepieces and examination lenses. The awareness of ophthalmologists regarding the possible influence on the results of SAP and IOP measurement by wearing a respirator was low in our questionnaire survey. It is therefore advisable to discuss this issue more widely and warn doctors about these risks.
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Zein M, Wylegala A, Sripawadkul W, Al Bayyat G, Alvarez OP, Gutierrez AJ, Guerrero MA, Galor A, Karp CL. Corneal topography and tomography readings with mask wear during the COVID-19 pandemic. J Cataract Refract Surg 2023; 49:285-291. [PMID: 36399667 PMCID: PMC10043756 DOI: 10.1097/j.jcrs.0000000000001090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To assess the effect of mask wear on corneal topography and tomography readings. SETTING Tertiary ophthalmic center. DESIGN Prospective, observational, comparative study. METHODS Subjects underwent imaging with the Tomey TMS-4a topographer and the Oculus Pentacam HR tomographer. Imaging was performed without a mask, and then testing was repeated while wearing 3 different masks: Halyard Level 2, Halyard Level 3, and KN95. Measurements during mask wear were compared with measurements without a mask. The Kruskal-Wallis analysis of variance grouped test was used to compare mean differences without vs with mask wear on measurements. The Chi-square test was used to compare frequency of differences between different masks and against-the-rule vs with-the-rule astigmatism. The frequencies of clinically significant changes in axis of astigmatism, magnitude of astigmatism, and mean keratometry (K) values were calculated. RESULTS 52 eyes were included in the study with a mean age of 34.71. Mask wear did not show statistically significant differences in mean topography and tomography measurements compared with without mask wear for all parameters. However, the majority, 53% (83/156) had a >10 degrees and 41% (64/156) had >15 degrees change in axis of astigmatism on topography when wearing a mask compared with no mask wear. CONCLUSIONS Mask wear did not result in statistically significant mean changes in K readings on topography and tomography. However, the axis of astigmatism varied >10 degrees in most of the patients. Axis determination should be interpreted with caution regarding refractive surgery and/or toric intraocular lens planning in individuals whose measurements were obtained while wearing a mask.
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Affiliation(s)
- Mike Zein
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida (Zein, Wylegala, Sripawadkul, Al Bayyat, Alvarez, Gutierrez, Guerrero, Galor, Karp); Department of Ophthalmology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand (Sripawadkul); Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, Florida (Galor)
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Balestracci B, La Regina M, Di Sessa D, Mucci N, Angelone FD, D'Ecclesia A, Fineschi V, Di Tommaso M, Corbetta L, Lachman P, Orlandini F, Tanzini M, Tartaglia R, Squizzato A. Patient safety implications of wearing a face mask for prevention in the era of COVID-19 pandemic: a systematic review and consensus recommendations. Intern Emerg Med 2023; 18:275-296. [PMID: 36103082 PMCID: PMC9472745 DOI: 10.1007/s11739-022-03083-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/11/2022] [Indexed: 02/01/2023]
Abstract
In the past, the use of face masks in western countries was essentially limited to occupational health. Now, because of the COVID-19 pandemic, mask-wearing has been recommended as a public health intervention. As potential side effects and some contraindications are emerging, we reviewed the literature to assess the impact of them in daily life on patient safety and to provide appropriate guidelines and recommendations. We performed a systematic review of studies investigating physiological impact, safety, and risk of masks in predefined categories of patients, which have been published in peer-reviewed journals with no time and language restrictions. Given the heterogeneity of studies, results were analyzed thematically. We used PRISMA guidelines to report our findings. Wearing a N95 respirator is more associated with worse side effects than wearing a surgical mask with the following complications: breathing difficulties (reduced FiO2, SpO2, PaO2 increased ETCO2, PaCO2), psychiatric symptoms (panic attacks, anxiety) and skin reactions. These complications are related to the duration of use and/or disease severity. Difficulties in communication is another issue to be considered especially with young children, older person and people with hearing impairments. Even if benefits of wearing face masks exceed the discomfort, it is recommended to take an "air break" after 1-2 h consecutively of mask-wearing. However, well-designed prospective studies are needed. The COVID-19 pandemic could represent a unique opportunity for collecting large amount of real-world data.
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Affiliation(s)
- Beatrice Balestracci
- SC Governo e rischio clinico, programmazione sanitaria e controllo di gestione, Azienda Sociosanitaria Ligure 5 (ASL5), La Spezia, Italy
| | - Micaela La Regina
- SC Governo e rischio clinico, programmazione sanitaria e controllo di gestione, Azienda Sociosanitaria Ligure 5 (ASL5), La Spezia, Italy.
| | - Domenico Di Sessa
- SC Governo e rischio clinico, programmazione sanitaria e controllo di gestione, Azienda Sociosanitaria Ligure 5 (ASL5), La Spezia, Italy
| | - Nicola Mucci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | | | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University, Rome, Italy
| | - Mariarosaria Di Tommaso
- Department of Gynaecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy
| | - Lorenzo Corbetta
- Department of Interventional Pneumology, University of Florence, Florence, Italy
| | - Peter Lachman
- Lead Faculty Quality Improvement Programme- Royal College of Physicians of Ireland, Dublin, Ireland
| | | | | | - Riccardo Tartaglia
- Department of Innovation and Information Engineering, G. Marconi University, Rome, Italy
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Abu-Ismail L, Al-Shami K, Al-Shami M, Nashwan AJ. The effect of COVID-19 pandemic and wearing face masks on ophthalmology practice: What is known so far? A narrative review. Front Med (Lausanne) 2022; 9:1019434. [PMID: 36518743 PMCID: PMC9742357 DOI: 10.3389/fmed.2022.1019434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/07/2022] [Indexed: 08/29/2023] Open
Abstract
Face masks, along with other preventive measures, can help slow the spread of COVID-19. Despite the positive effect of the mask in combating the virus, it has some negative effects on the human body that must be followed up on and reduced. In this study, we discuss the impact of wearing face masks on the eye and the common issues associated with using them. The literature search was conducted using electronic databases such as PubMed and Google Scholar. Only articles published in English were included. A total of 39 relevant articles were deemed eligible. After the duplicate articles were removed, the titles and abstracts of 20 papers underwent full-text screening. The review comprised both prospective and retrospective investigations, case reports, and a series of reporting ocular symptoms following the use of face masks. The COVID-19 pandemic affected ophthalmology practices in managing patients. New factors must be considered, especially when dealing with anti-VEGF injections, such as the risk of endophthalmitis, tests and symptoms of patients with glaucoma, and the emerging symptoms associated with the COVID-19 vaccination. The use of face masks and breathing aids seemed to influence the tear film.
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Affiliation(s)
- Luai Abu-Ismail
- Department of Ophthalmology, Islamic Hospital, Amman, Jordan
| | - Khayry Al-Shami
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Manar Al-Shami
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
- Princess Basma Hospital, Ministry of Health, Irbid, Jordan
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Remote Video Monitoring of Simultaneous Visual Field Testing. J Glaucoma 2022; 31:488-493. [PMID: 35763679 DOI: 10.1097/ijg.0000000000002045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/13/2022] [Indexed: 01/31/2023]
Abstract
PRCIS In this prospective interventional case series that included 474 patients, there were no significant differences in visual field (VF) parameters between fields from patients tested one-at-a-time and simultaneously, except for fixation losses. PURPOSE To test for differences in reliability and performance parameters of patients taking VF tests while using a remote patient monitoring system to supervise 1 or 2 test sessions simultaneously. METHODS In a prospective interventional case series, 861 eyes of 474 consecutive patients undergoing automated perimetry during a 6-month period were monitored during the test using an audio/video-enabled remote monitoring system. Two patients were simultaneously tested (simultaneous test) by a single technician if they were ready for testing at the same time. Patients were otherwise tested individually (single test). Performance and reliability parameters including false negatives, false positives, fixation losses, mean deviation, pattern standard deviation, VF index, and test duration were compared between patients undergoing simultaneous tests and single tests. Patients undergoing remotely monitored testing, for whom a prior VF could be found, had performance and reliability parameters compared with those prior tests. VFs were analyzed separately for 2 test strategies: SITA Standard 24-2 and SITA Faster 24-2C. RESULTS No significant parameter differences were observed among SITA Standard 24-2 VFs between single and simultaneous tests, except for fixation losses (single: 16.8±19.7%, simultaneous: 22.5±25.0%, P=0.01). Similarly, there were no significant differences observed among SITA Faster 24-2C tests. Paired analyses comparing remotely monitored VFs with prior traditionally monitored VFs showed no significant differences for any parameters, except for fewer fixation losses with remote monitoring (traditional: 23.6±27.5%, remote 17.7±20.8%, P=0.003). CONCLUSIONS Remote patient monitoring of VF testing enabled technicians to supervise testing of 2 patients simultaneously with preserved performance and reliability.
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El-Nimri NW, Micheletti E, Mohammadzadeh V, Nishida T, Kamalipour A, Zangwill LM, Bowd C, Moghimi S, Weinreb RN. OCT-Angiography Face Mask-Associated Artifacts During the COVID-19 Pandemic. J Glaucoma 2022; 31:399-405. [PMID: 35320142 PMCID: PMC9148637 DOI: 10.1097/ijg.0000000000002019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/10/2022] [Indexed: 11/26/2022]
Abstract
PRCIS Face mask wearing has no significant effects on artifacts or vessel density measurements in optic nerve head (ONH) and macular optical coherence tomography-angiography (OCT-A) scans. PURPOSE The aim was to assess the difference in area of artifacts observed in optical OCT-A scans with and without face mask wear and to verify if mask wear interferes with OCT-A vessel density measurements. SUBJECTS AND CONTROLS A total of 64 eyes of 10 healthy subjects, 4 ocular hypertensive, 8 glaucoma suspects, and 17 glaucoma patients were included. MATERIALS AND METHODS High-density ONH and macula OCT-A scans were obtained in patients with and without surgical masks. Seven different artifacts (motion, decentration, defocus, shadow, segmentation failure, blink, and Z-offset) were quantitatively evaluated by 2 trained graders. The changes in the area (% of scan area) of artifacts, without and with mask wearing, and differences of vessel density were evaluated. RESULTS Trends of increasing motion artifact area for the ONH scans [4.23 (-0.52, 8.98) %, P=0.08] and defocus artifact area for the macular scans [1.06 (-0.14, 2.26) %, P=0.08] were found with face mask wear. However, there were no significant differences in the mean % area of any artifacts (P>0.05 for all). Further, the estimated mean difference in vessel density in images acquired without and with masks was not significant for any type of artifact. CONCLUSION Face mask wearing had no significant effect on area of artifacts or vessel density measurements. OCT-A vessel density measurements can be acquired reliably with face mask wear during the pandemic.
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Affiliation(s)
- Nevin W. El-Nimri
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Eleonora Micheletti
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Vahid Mohammadzadeh
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Linda M. Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Christopher Bowd
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
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Pabolu C, Srinivasan K, Upadhyaya S. Letter to the Editor: The Impacts of Face Mask Use on Standard Automated Perimetry Results in Glaucoma Patients. J Glaucoma 2021; 30:1015. [PMID: 34474419 DOI: 10.1097/ijg.0000000000001932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bayram N, Gundogan M, Ozsaygili C, Vural E, Cicek A. Response to Letter to the Editor: The Impacts of Face Mask Use on Standard Automated Perimetry Results in Glaucoma Patients. J Glaucoma 2021; 30:1015-1016. [PMID: 34474420 DOI: 10.1097/ijg.0000000000001931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Nurettin Bayram
- Department of Ophthalmology, Kayseri City Training and Research Hospital University of Health Science Kayseri, Turkey
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Heidinger A, Falb T, Werkl P, List W, Hoeflechner L, Riedl R, Ivastinovic D, Hommer A, Lindner E. The Impact of Tape Sealing Face Masks on Visual Field Scores in the Era of COVID-19: A Randomized Cross-over Study. J Glaucoma 2021; 30:878-881. [PMID: 34387258 PMCID: PMC8483650 DOI: 10.1097/ijg.0000000000001922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/28/2021] [Indexed: 11/26/2022]
Abstract
PRECIS Tape sealing of the face mask can prevent fogging artifacts of visual field testing. Here, we demonstrate that tape sealing can improve visual field scores even when fogging artifacts are not obvious. PURPOSE The purpose of this study was to demonstrate that visual field scores improve when the face masks are taped to prevent fogging artifacts. METHODS A Single-center, randomized 2×2 cross-over study. Twenty-six visual fields of 13 patients of the glaucoma outpatient clinic were included. Patients were randomized in either sequence 1 (Octopus visual field examination without tape sealing, followed by examination with tape sealing) or sequence 2 (examination with, followed by without tape sealing). RESULTS The results for mean defect and square root of loss variance differ significantly in the examination with and without tape sealing [mean difference (without-with) 0.39 dB, 95% confidence interval: 0.07-0.70 dB, P=0.018 and 0.49 dB, 95% confidence interval: 0.19-0.79 dB, P=0.003, respectively]. There was no sequence effect (P=0.967) for mean defect nor the square root of loss variance (P=0.779). A significant effect for period (P=0.023) for mean defect was yielded. CONCLUSION Tape sealing of face masks during visual field testing prevented fogging artifacts and improved visual field scores even when fogging artifacts were not obvious and should be considered in clinical practice.
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Affiliation(s)
| | | | | | | | | | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz
| | | | - Anton Hommer
- Department of Ophthalmology, Sanatorium Hera, Vienna, Austria
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Ramesh PV, Ramesh SV, Ray P, Aji K, Ramesh MK, Rajasekaran R. The curious cases of incorrect face mask positions in bowl-type perimetry versus enclosed chamber perimetry during the COVID-19 pandemic. Indian J Ophthalmol 2021; 69:2236-2239. [PMID: 34304223 PMCID: PMC8482892 DOI: 10.4103/ijo.ijo_805_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Prasanna V Ramesh
- Medical Officer, Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
| | - Shruthy V Ramesh
- Medical Officer, Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
| | - Prajnya Ray
- Optometrist, Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
| | - K Aji
- Optometrist, Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
| | - Meena K Ramesh
- Head of the Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
| | - Ramesh Rajasekaran
- Chief Medical Officer, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
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Hattenbach LO, Feltgen N, Eter N, Al-Nawaiseh S, Chronopoulos A. Ophthalmic Outpatient and Inpatient Care Under Pandemic Conditions: Hygiene, Triage and New Challenges. Klin Monbl Augenheilkd 2021; 238:561-568. [PMID: 34020484 DOI: 10.1055/a-1487-1742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The progression of the COVID-19 pandemic has caused significant changes in the environment for outpatient and inpatient care in ophthalmology, with limitations on access to medical care but also new observations and challenges. We now describe major developments in recent months and provide an outlook on the expected consequences. METHODS PubMed literature search, clinical survey. RESULTS To date, the course of the COVID-19 pandemic has been characterised by several new but overall rare ocular manifestations, the ophthalmological shared management of COVID-19 patients on intensive care units, and a significant decrease in case numbers, associated with an increase in case severity and relative proportion of emergencies, as a result of delayed presentation of patients and reduced treatment adherence. With the introduction of hygiene measures and infection control procedures, ophthalmic patient care was maintained - including emergencies and urgent treatments. Due to the extensive postponement of elective surgeries, scarce therapeutic and health care professional resources, and the prioritisation of critically ill patients from other specialties, there is a reasonable likelihood that urgent treatments will be delayed as infection rates rise. CONCLUSION Outpatient and inpatient care in ophthalmology during the COVID-19 pandemic is primarily accompanied by additional organisational or medical challenges and a decline in case volume. Although to date emergency and urgent ophthalmic treatments have been maintained, long-term persistence of pandemic conditions will require additional strategies to provide continuation of ophthalmic care at the required level.
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Affiliation(s)
| | | | - Nicole Eter
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Deutschland
| | - Sami Al-Nawaiseh
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Deutschland
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