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V Carvalho AS, Broekema B, Brito Fernandes Ó, Klazinga N, Kringos D. Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020-2021): a scoping review. BMC Emerg Med 2024; 24:19. [PMID: 38273229 PMCID: PMC10811879 DOI: 10.1186/s12873-024-00938-7] [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: 03/14/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic severely impacted care for non-COVID patients. Performance indicators to monitor acute care, timely reported and internationally accepted, lacked during the pandemic in OECD countries. This study aims to summarize the performance indicators available in the literature to monitor changes in the quality of acute care in OECD countries during the first year and a half of the pandemic (2020-July 2021) and to assess their trends. METHODS Scoping review. Search in Embase and MEDLINE (07-07-2022). Acute care performance indicators and indicators related to acute general surgery were collected and collated following a care pathway approach. Indicators assessing identical clinical measures were grouped under a common indicator title. The trends from each group of indicators were collated (increase/decrease/stable). RESULTS A total of 152 studies were included. 2354 indicators regarding general acute care and 301 indicators related to acute general surgery were included. Indicators focusing on pre-hospital services reported a decreasing trend in the volume of patients: from 225 indicators, 110 (49%) reported a decrease. An increasing trend in pre-hospital treatment times was reported by most of the indicators (n = 41;70%) and a decreasing trend in survival rates of out-of-hospital cardiac arrest (n = 61;75%). Concerning care provided in the emergency department, most of the indicators (n = 752;71%) showed a decreasing trend in admissions across all levels of urgency. Concerning the mortality rate after admission, most of the indicators (n = 23;53%) reported an increasing trend. The subset of indicators assessing acute general surgery showed a decreasing trend in the volume of patients (n = 50;49%), stability in clinical severity at admission (n = 36;53%), and in the volume of surgeries (n = 14;47%). Most of the indicators (n = 28;65%) reported no change in treatment approach and stable mortality rate (n = 11,69%). CONCLUSION This review signals relevant disruptions across the acute care pathway. A subset of general surgery performance indicators showed stability in most of the phases of the care pathway. These results highlight the relevance of assessing this care pathway more regularly and systematically across different clinical entities to monitor disruptions and to improve the resilience of emergency services during a crisis.
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Affiliation(s)
- Ana Sofia V Carvalho
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands.
| | - Bente Broekema
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Department of Pediatrics, Dijklander Hospital, Location Hoorn, Maelsonstraat 3, Hoorn, 1624 NP, The Netherlands
| | - Óscar Brito Fernandes
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Niek Klazinga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Dionne Kringos
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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Zhou H, Liao R, Zhang D, Wang W, Deng S. Glaucoma Characteristics and Influencing Factors during the COVID-19 Pandemic in the Huizhou Region. J Ophthalmol 2023; 2023:8889754. [PMID: 37927894 PMCID: PMC10622592 DOI: 10.1155/2023/8889754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Glaucoma in individuals who tested positive for the coronavirus disease 2019 (COVID-19) during the pandemic outbreak has not been comprehensively studied. Therefore, this study aimed to analyze the characteristics and risk factors of glaucoma during the COVID-19 pandemic in Huizhou. Methods Retrospective data from outpatients with glaucoma at the Huizhou Hospital Affiliated with Guangzhou Medical University and Longmen County People's Hospital were collected during two periods: the COVID-19 pandemic period (Phase A: December 1, 2022, to January 19, 2023) and the prevention and control period (Phase B: December 1, 2021, to January 19, 2022). The demographic characteristics of the outpatients during both phases were compared. The characteristics of glaucoma in patients with COVID-19 during Phase A were examined. Multivariate logistic regression analysis was used to identify factors influencing the development of acute angle-closure glaucoma (AACG) in Phase A patients. Results The proportion of patients with glaucoma was significantly higher during Phase A than during Phase B at both hospitals. No statistically significant differences were observed between patients with glaucoma during Phases A and B for age, sex, and region. A high COVID-19-positive rate was associated with old age, females, AACG, newly diagnosed glaucoma, and binocular involvement during phase A. Females testing positive for COVID-19, glaucoma that started after testing positive for COVID-19, and a history of medication use were associated with a higher proportion of AACG in phase A. Multivariable logistic regression analysis identified testing positive for COVID-19 as an independent potential risk factor for developing AACG. Conclusion In summary, during the COVID-19 pandemic in Huizhou, patients with COVID-19 were primarily affected by AACG, especially females, older individuals, and those with binocular involvement. Testing positive for COVID-19 increases the risk of developing AACG.
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Affiliation(s)
- Huilan Zhou
- Huizhou Hospital Affiliated to Guangzhou Medical University (Huizhou Third People's Hospital), Huizhou 516000, Guangdong, China
| | - Rui Liao
- Huizhou Hospital Affiliated to Guangzhou Medical University (Huizhou Third People's Hospital), Huizhou 516000, Guangdong, China
| | - Dongxuan Zhang
- Huizhou Hospital Affiliated to Guangzhou Medical University (Huizhou Third People's Hospital), Huizhou 516000, Guangdong, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510000, Guangdong, China
| | - Shuifeng Deng
- Huizhou Hospital Affiliated to Guangzhou Medical University (Huizhou Third People's Hospital), Huizhou 516000, Guangdong, China
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Kaur K, Muralikrishnan J, Hussaindeen JR, Deori N, Gurnani B. Impact of Covid-19 on Pediatric Ophthalmology Care: Lessons Learned. Pediatric Health Med Ther 2023; 14:309-321. [PMID: 37849985 PMCID: PMC10578174 DOI: 10.2147/phmt.s395349] [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: 06/27/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023] Open
Abstract
The COVID-19 pandemic came with many new challenges that forced personal and professional lifestyle modifications. Medical facilities were in scarcity against this new unknown enemy and were challenged with the overloaded patient flow, scarcity of healthcare staff, and evolving treatment modalities with a better understanding of the virus each day. Ophthalmology as a "branch of medicine" suffered challenges initially because of a lack of guidelines for patient management, close working distance during routine examinations, and halt of major surgeries, including cataracts. Pediatric ophthalmology had major implications, as reduced outpatient visits would mean deeper amblyopia, and changed lifestyles, including online classes and home refinement, predisposing children to myopia, digital eye strain, and worsening of strabismus. COVID-19 also unveiled underlying accommodation and convergence anomalies that predisposed pediatric and adolescent patients to an increased prevalence of headache and acute onset esotropia. Teleophthalmology and other innovative solutions, including the use of prism glasses, safe slit-lamp shields, alternative ways of school screening with the use of photoscreeners, performing retinoscopy only when needed, and using autorefractors were among the few guidelines or modifications adopted which helped in the efficient and safe management of pediatric patients. Many pediatric ophthalmologists also suffered in terms of financial constraints due to loss of salary or even closure of private practices. School screening and retinopathy of prematurity screening suffered a great setback and costed a lot of vision years, data of which remains under-reported. Important implications and learnings from the pandemic to mitigate future similar situations include using teleophthalmology and virtual platforms for the triage of patients, managing non-emergency conditions without physical consultations, and utilizing home-based vision assessment techniques customized for different age groups. Though this pandemic had a lot of negative implications, the innovations, modifications, and other important learnings helped pediatric ophthalmologists in navigating safely.
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Affiliation(s)
- Kirandeep Kaur
- Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Janani Muralikrishnan
- Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Chennai, India
| | | | - Nilutparna Deori
- Department of Pediatric Ophthalmology and Strabismus, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Bharat Gurnani
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
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Mahjoub H, Ssekasanvu J, Yonekawa Y, Justin GA, Cavuoto KM, Lorch A, Madan V, Sivakumar I, Zhao X, Quintero M, Simeon OF, Salabati M, Wu CM, Woreta FA. Most Common Ophthalmic Diagnoses in Eye Emergency Departments: A Multicenter Study. Am J Ophthalmol 2023; 254:36-43. [PMID: 36965840 DOI: 10.1016/j.ajo.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/24/2023] [Accepted: 03/11/2023] [Indexed: 03/27/2023]
Abstract
PURPOSE To characterize the most common ophthalmic conditions seen in the emergency department (ED) DESIGN: Cross-sectional study METHODS: This is a multicenter study of 64,988 patients who visited the Bascom Palmer Eye Institute, Massachusetts Eye and Ear, Wills Eye Hospital, and Johns Hopkins Hospital/Wilmer Eye Institute from January 1, 2019, until December 31, 2019. Demographic and primary diagnosis data were extracted including gender, age, race, ethnicity, insurance type, and ophthalmology consult status. Descriptive statistics were performed on all data using STATA IC 14 (64-bit). RESULTS A total of 64,988 patients with primary ocular diagnoses were seen across all 4 EDs. The majority of patients were White (63.1%), non-Hispanic/Latino (64.8%), and female (52.3%). The most frequently seen age group was 50-64 years (28.6%). The most common diagnoses across all institutions were conjunctivitis (7.91%), corneal abrasions (5.61%), dry eye (4.49%), posterior vitreous detachments (4.15%), chalazions (3.71%), corneal ulcers (3.01%), subconjunctival hemorrhages (2.96%), corneal foreign bodies (2.94%), retinal detachments (2.51%), and glaucoma (2.12%). Specifically, viral conjunctivitis (2283 of 5139, 44.4%) and primary open-angle glaucoma (382 of 1379, 27.7%) were the most frequently seen subtypes of conjunctivitis and glaucoma. CONCLUSIONS The most regularly treated ophthalmic conditions in high-volume EDs tend to be lower acuity diagnoses. To combat ED overcrowding and rising health care costs in the United States, we suggest diverting eye-related ED visits to a specialized eye ED service or same-day eye clinic appointment in addition to expanding education for patients and primary care clinicians.
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Affiliation(s)
- Heba Mahjoub
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital (F.A.W.)
| | - Joseph Ssekasanvu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (J.S.)
| | - Yoshihiro Yonekawa
- Wills Eye Hospital Retina Service, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania (Y.Y., M.S.)
| | - Grant A Justin
- Department of Ophthalmology, Duke Eye Center, Durham, North Carolina (G.A.J.)
| | - Kara M Cavuoto
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida (K.M.C.)
| | - Alice Lorch
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts (A.L.)
| | - Vrinda Madan
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland (V.M., I.S., X.Z., M.Q., O.F.S.)
| | - Ishwarya Sivakumar
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland (V.M., I.S., X.Z., M.Q., O.F.S.)
| | - Xiyu Zhao
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland (V.M., I.S., X.Z., M.Q., O.F.S.)
| | - Michael Quintero
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland (V.M., I.S., X.Z., M.Q., O.F.S.)
| | - Olivia Febles Simeon
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland (V.M., I.S., X.Z., M.Q., O.F.S.)
| | - Mirataollah Salabati
- Wills Eye Hospital Retina Service, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania (Y.Y., M.S.)
| | - Connie M Wu
- Wills Eye Hospital Retina Service, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania (Y.Y., M.S.)
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital (F.A.W.).
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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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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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Pourmasumi S, Kounis NG, Naderi M, Hosseinisadat R, Khoradmehr A, Fagheirelahee N, Kouni SN, de Gregorio C, Dousdampanis P, Mplani V, Michalaki MA, Plotas P, Assimakopoulos S, Gogos C, Aidonidis G, Roditis P, Matsas N, Velissaris D, Calogiuri G, Hung MY, Koniari I. Effects of COVID-19 Infection and Vaccination on the Female Reproductive System: A Narrative Review. Balkan Med J 2023; 40:153-164. [PMID: 37114907 PMCID: PMC10175880 DOI: 10.4274/balkanmedj.galenos.2023.2023-3-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Several studies and research papers have been published to elucidate and understand the mechanism of the coronavirus disease 2019 (COVID-19) pandemic and its long-term effects on the human body. COVID-19 affects a number of organs, including the female reproductive system. However, less attention has been given to the effects of COVID-19 on the female reproductive system due to their low morbidity. The results of studies investigating the relationship between COVID-19 infection and ovarian function in women of reproductive age have shown the harmless involvement of COVID-19 infection. Several studies have reported the involvement of COVID-19 infection in oocyte quality, ovarian function, and dysfunctions in the uterine endometrium and the menstrual cycle. The findings of these studies indicate that COVID-19 infection negatively affects the follicular microenvironment and dysregulate ovarian function. Although the COVID-19 pandemic and female reproductive health have been studied in humans and animals, very few studies have examined how COVID-19 affects the female reproductive system. The objective of this review is to summarize the current literature and categorize the effects of COVID-19 on the female reproductive system, including the ovaries, uterus, and hormonal profiles. The effects on oocyte maturation, oxidative stress, which causes chromosomal instability and apoptosis in ovaries, in vitro fertilization cycle, high-quality embryos, premature ovarian insufficiency, ovarian vein thrombosis, hypercoagulable state, women’s menstrual cycle, the hypothalamus-pituitary-ovary axis, and sex hormones, including estrogen, progesterone, and the anti-Müllerian hormone, are discussed in particular.
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Affiliation(s)
- Soheila Pourmasumi
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Nicholas G. Kounis
- Department of Internal Medicine, Division of Cardiology, University of Patras Medical School, Patras, Greece
| | - Monavar Naderi
- Knowledge and Information Science, Vice Chancellor for Science and Technology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Robabe Hosseinisadat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Arezoo Khoradmehr
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Niloofar Fagheirelahee
- Department of Anatomy, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Cesare de Gregorio
- Department of Clinical and Experimental Medicine, University of Messina Medical School, Messina, Italy
| | | | - Virginia Mplani
- Intensive Care Unit, Patras University Hospital, Patras, Greece
| | - Marina A. Michalaki
- Department of Internal Medicine, Division of Endocrinology, Fculty of Health Sciences, University of Patras, Patras, Greece
| | | | - Stelios Assimakopoulos
- Department of Internal Medicine, Division of Infectious Diseases, University of Patras Medical School, Patras, Greece
| | - Christos Gogos
- COVID-19 Unit, Papageorgiou General Hospital, Thessaloniki, Greece
| | | | - Pavlos Roditis
- Department of Cardiology, Mamatsio Kozanis General Hospital, Kozani, Greece
| | | | | | - Gianfranco Calogiuri
- Pneumonology Department, Civil Hospital “Ninetto Melli”, Pietro Vernoti, Brindisi, Italy
- Department of Internal Medicine, Immunology and Infectious Diseases, Section of Allergology and Clinical Immunology, University of Bari Medical School, Bari, Italy
| | - Ming-Yow Hung
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
| | - Ioanna Koniari
- Departmentof Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
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Baudin F, Benzenine E, Mariet AS, Ben Ghezala I, Daien V, Gabrielle PH, Quantin C, Creuzot-Garcher CP. Impact of COVID-19 lockdown on surgical procedures for retinal detachment in France: a national database study. Br J Ophthalmol 2023; 107:565-569. [PMID: 34799368 PMCID: PMC8609492 DOI: 10.1136/bjophthalmol-2021-319531] [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: 04/26/2021] [Accepted: 11/06/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS The COVID-19 crisis and the decisions made regarding population lockdown may have changed patient care. We aimed to investigate the incidence rate of rhegmatogenous retinal detachment (RRD) cases during the COVID-19 lockdown period. METHODS In this nationwide database study, we identified hospital and clinic admissions of French residents for a first episode of RRD in France from 2017 to the lockdown period in 2020. The monthly hospital incidence rates of RRD procedures per 100 000 inhabitants before, during and after lockdown were computed for the whole country. Finally, we assessed the influence of viral incidence on the RRD incidence rate, comparing two regions with highly contrasting viral penetration. RESULTS From January to July, the average monthly national hospital incidence rate of RRD decreased from a mean of 2.59/100 000 inhabitants during 2017-2019 to 1.57/100 000 inhabitants in 2020. Compared with 2019, during the 8-week lockdown period in 2020, a 41.6% decrease in the number of RRD procedures was observed (p<0.001) with the weekly incidence of RRD decreasing from 0.63/100 000 inhabitants in 2019 to 0.36/100 000 inhabitants. During the 4-month post-lockdown period, no increased activity related to postponed procedures was observed. No difference was found in the rate of RRD surgery when comparing two regions with highly contrasting viral incidence. CONCLUSION Containment may have been responsible for a decrease in the number of surgical procedures for RRD, without any compensating post-lockdown activity in France. These results might help increase awareness of the management of RRD emergencies.
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Affiliation(s)
- Florian Baudin
- Ophthalmology, University Hospital Centre Dijon, Dijon, France
- Équipe d'Accueil (EA 7460): Physiopathologie et Épidémiologie Cérébro-Cardiovasculaires (PEC2), Burgundy Franche-Comté University, Dijon, France
| | - Eric Benzenine
- Biostatistics and Bioinformatics (DIM), University Hospital Centre Dijon, Dijon, France
| | - Anne-Sophie Mariet
- Biostatistics and Bioinformatics (DIM), University Hospital Centre Dijon, Dijon, France
- Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, INSERM CIC1432, University Hospital Centre Dijon, Dijon, France
| | - Inès Ben Ghezala
- Ophthalmology, University Hospital Centre Dijon, Dijon, France
- Équipe d'Accueil (EA 7460): Physiopathologie et Épidémiologie Cérébro-Cardiovasculaires (PEC2), Burgundy Franche-Comté University, Dijon, France
| | - Vincent Daien
- Ophthalmology, University Hospital Montpellier, Montpellier, France
- Epidemiology, INSERM, U1061, Montpellier, France
| | - Pierre-Henry Gabrielle
- Ophthalmology, University Hospital Centre Dijon, Dijon, France
- Eye and Nutrition Research Group, Taste and Food Science Center, Burgundy Franche-Comté University, Dijon, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital Centre Dijon, Dijon, France
- Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, INSERM CIC1432, University Hospital Centre Dijon, Dijon, France
| | - Catherine P Creuzot-Garcher
- Ophthalmology, University Hospital Centre Dijon, Dijon, France
- Eye and Nutrition Research Group, Taste and Food Science Center, Burgundy Franche-Comté University, Dijon, France
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Delavar A, Bu JJ, Radha Saseendrakumar B, Weinreb RN, Baxter SL. Mental health and social support among glaucoma patients enrolled in the NIH All of Us COVID-19 Participant Experience (COPE) survey. BMC Ophthalmol 2023; 23:63. [PMID: 36782129 PMCID: PMC9923653 DOI: 10.1186/s12886-023-02771-1] [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: 04/11/2022] [Accepted: 01/04/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic created many challenges for our society. In this study, we explore how measures of mental health, coping strategies, and social support during the pandemic varied by glaucoma status. METHODS A cohort of patients aged 40 and over enrolled in the NIH All of Us Research Program, a nationwide longitudinal cohort, who answered the COVID-19 Participant Experience (COPE) survey was obtained. We analyzed several measures of mental health, coping strategies, and social support used during the early stages of the COVID-19 pandemic. Surveys were recurring and answered from May 2020 to February 2021. Demographics and the most recently answered survey responses were obtained and stratified by glaucoma status. Pearson's Chi-squared tests and multivariable logistic regressions adjusting for age, gender, race, ethnicity, and income were used to generate p-values, odds ratios (ORs) and 95% confidence intervals (CIs) between outcome measures and glaucoma status. RESULTS Of 42,484 patients who responded to All of Us COPE survey items, 2912 (6.9%) had a diagnosis of glaucoma. On Pearson's Chi-squared tests glaucoma patients were less likely to report drinking alcohol (P = 0.003), eating more food than usual (P = 0.004), and using marijuana (P = 0.006) to cope with social distancing than those without a diagnosis of glaucoma. Further, glaucoma patients had lower rates of probable mild, moderate, or severe depression as calculated by Patient Health Questionnaire-9 (PHQ-9) scores (P < 0.001) and had lower rates of reporting some or a lot of stress from social distancing (P < 0.001). However, glaucoma patients were less likely to report having someone to help prepare meals (P = 0.005) or help with daily chores (P = 0.003) if they became sick with COVID-19. In multivariable logistic regression analyses adjusting for confounding factors, no differences were found for measures of mental health or social support. CONCLUSIONS Glaucoma patients did not fare worse on many measures of mental health and coping strategies during the early stages of the COVID-19 pandemic compared those without glaucoma. However, a substantial proportion of glaucoma patients still endorsed stress, social isolation, and probable depression, representing challenges for disease management.
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Affiliation(s)
- Arash Delavar
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
| | - Jennifer J. Bu
- grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
| | - Bharanidharan Radha Saseendrakumar
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
| | - Robert N. Weinreb
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Sally L. Baxter
- grid.266100.30000 0001 2107 4242Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA USA ,grid.266100.30000 0001 2107 4242Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA 92093 USA
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10
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Chaudhry Z, Santhakumaran S, Schwartz J, Toffoli D. Impact of COVID-19 on pediatric ophthalmology in the epicentre of the Canadian outbreak. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:e16-e17. [PMID: 35271847 PMCID: PMC8841153 DOI: 10.1016/j.jcjo.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/18/2022] [Accepted: 02/08/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Zoya Chaudhry
- Department of Ophthalmology and Visual Sciences, McGill University, Montreal, Que,Department of Ophthalmology, Montreal Children's Hospital, Montreal, Que
| | | | - Jake Schwartz
- Faculty of Medicine, McGill University, Montreal, Que
| | - Daniela Toffoli
- Department of Ophthalmology and Visual Sciences, McGill University, Montreal, Que,Department of Ophthalmology, Montreal Children's Hospital, Montreal, Que
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11
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How should we report the foveal status in eyes with "macula-off" retinal detachment? Eye (Lond) 2023; 37:228-234. [PMID: 35505112 PMCID: PMC9873750 DOI: 10.1038/s41433-022-02074-7] [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: 12/10/2021] [Revised: 04/06/2022] [Accepted: 04/19/2022] [Indexed: 01/28/2023] Open
Abstract
Whilst pre- and postoperative multimodal imaging technologies including optical coherence tomography (OCT) have investigated the morphological correlates of worsened visual outcomes in rhegmatogenous retinal detachment (RRD) with foveal involvement, the nomenclature has adhered to the traditional ophthalmoscopy-based and rather vague term "macula-off". This article appraises the current literature with regard to the preoperative assessment and nomenclature of the foveal status in macula involving retinal detachment (MIRD). A literature review of recent publications assessing functional or morphological outcomes in MIRD was conducted, using the search terms "fovea-off" or "macula-off". The search date was April 28th, 2021. Original studies in English language were included. Case reports, review articles or letters were excluded. Forty relevant articles (range of publication dates: July 29th, 2020 - April 18th, 2021) were reviewed to assess the diagnostic modalities used, morphological parameters assessed, and any specific nomenclature introduced to specify the extent of macular detachment. The results suggest widespread variability and inconsistencies with regard to the preoperative assessment, diagnostic modalities and nomenclature used to describe the foveal status in eyes with RRD termed "macula-off". The extent of macular detachment may be classified by a wide range of morphological parameters, including the height of foveal detachment and the ETDRS grid as overlay tool in OCT devices. There is a scientific and clinical need for an updated nomenclature for eyes with "macula-off" RRD. Preoperative OCT findings should be reported on a regular and standardized basis in order to establish a consensus how to report the foveal status in eyes with MIRD.
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12
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Bruzard H, Soler P, Varenne F, Sentis V, Fournié P, Soler V. [Influence of the COVID-19 pandemia on the ophthalmologic emergency department in the Toulouse University Hospital during the first lockdown from March the 17th to May the 10th of 2020]. J Fr Ophtalmol 2023; 46:2-10. [PMID: 36503813 PMCID: PMC9701637 DOI: 10.1016/j.jfo.2022.07.008] [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: 05/21/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION We conducted this study to assess the impact of the COVID-19 pandemic and the lockdown in France from March 17, 2020 to May 10, 2020, on the ophthalmic emergency department at Toulouse University Hospital, compared to the period from March 2 to March 16, 2020. MATERIALS AND METHODS This was a retrospective observational study, conducted in the ophthalmic emergency department of Toulouse University Hospital. We included the patients presenting to the emergency department from March 2 to May 10, 2020. We recorded age, sex, day of visit, time until care was received, past ocular history, outpatient or inpatient status, final diagnosis and its severity, outpatient or inpatient disposition, and medical or surgical treatment after the emergency department visit. RESULTS We found a substantial decrease in the number of patients per day, mostly during the first month of the lockdown: 44 patients per day before the lockdown compared to 23 patients per day during the first month, followed by 38 patients per day for the second month of lockdown; more patients visiting promptly; and elderly patients represented a higher proportion of patients. CONCLUSION The first lockdown in France due to the COVID-19 pandemic had an impact on the Toulouse ophthalmic emergency department, especially concerning the number of patients per day; this study helps to assess individual behavior in this context of a public health crisis.
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Affiliation(s)
- H. Bruzard
- Ophthalmology Department, Pierre-Paul-Riquet Hospital, Toulouse University Hospital, Toulouse, France,Auteur correspondant. 5, rue Jacob-Insel, Résidence Emeraude, Bâtiment D, Appartement 139, 31200 Toulouse, France
| | - P. Soler
- EFS Occitanie centre de soins, 1, avenue Irène-Joliot-Curie, Toulouse, France
| | - F. Varenne
- Ophthalmology Department, Pierre-Paul-Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - V. Sentis
- Ophthalmology Department, Pierre-Paul-Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - P. Fournié
- Ophthalmology Department, Pierre-Paul-Riquet Hospital, Toulouse University Hospital, Toulouse, France,Université Toulouse III, 31000 Toulouse, France
| | - V. Soler
- Ophthalmology Department, Pierre-Paul-Riquet Hospital, Toulouse University Hospital, Toulouse, France,Université Toulouse III, 31000 Toulouse, France,SV3 team, CERCO, UMR5549, Toulouse, France
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13
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Eissa M, Abdelrazek NA, Saady M. Covid-19 and its relation to the human eye: transmission, infection, and ocular manifestations. Graefes Arch Clin Exp Ophthalmol 2022:10.1007/s00417-022-05954-6. [PMID: 36585987 PMCID: PMC9803899 DOI: 10.1007/s00417-022-05954-6] [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: 09/21/2022] [Revised: 12/07/2022] [Accepted: 12/20/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The world is suffering from a new strain of the coronavirus family-Covid-19. This virus strain affected different organs in the human body with a wide range of mild symptoms and moderate signs to severe and deadly ones. Multiple organs can be infected, and one of these organs is the eye. The eye is a vital organ that consists of vascular tissues and is connected to the respiratory tract through the tears and the nasolacrimal duct. METHODS Recent papers and research from PubMed, Researchgate, and Google Scholar were cited and thoroughly discussed. These papers were chosen based on their relevancy, reliability, publication year, published journal, and ease of accessibility to the paper itself. RESULTS The theory concluded that the ocular surface might consider a pathway for the virus attack and infection causation through the tears and the angiotensin-converting enzyme 2 located in the eye. This article thoroughly reviewed the history, the existing aspects of Covid-19, the ocular system features, and the claims about the possible involvement of the eye in the virus transmission along with the eye infection. There was no consensus on the eye's involvement theory. CONCLUSION The authors highlighted the extra work and research needed to be conducted to prove or deny these claims to provide a better understanding of the immune response of the eye to Covid-19 infection.
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Affiliation(s)
- Mahmoud Eissa
- Ophthalmology, Royal Surrey County Hospital, Egerton Rd, Guildford, GU2 7XX, UK.
| | - Nada A Abdelrazek
- Department of Microbiology and Immunology, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt
| | - Marwa Saady
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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14
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Zhou L, Wu S, Wang Y, Bao X, Peng T, Luo W, Ortega-Usobiaga J. Clinical presentation of acute primary angle closure during the COVID-19 epidemic lockdown. Front Med (Lausanne) 2022; 9:1078237. [PMID: 36590933 PMCID: PMC9802666 DOI: 10.3389/fmed.2022.1078237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose This study aimed to investigate the clinical presentation of acute primary angle closure (APAC) during the COVID-19 epidemic lockdown in Wuhan. Methods Consecutive patients seeking APAC treatment at the Wuhan Aier Eye Hospital during the 76 days (January 23-April 8, 2020) when the lockdown policy was implemented due to the COVID-19 pandemic were compared to those during the same period the following year (January 23-April 8, 2021), when the lockdown policy was not implemented. The cohorts were compared to assess demographic variables and clinical presentations. Results A total of 54 patients (64 eyes) were included in the 2020, compared with 46 patients (51 eyes) in the 2021. Demographic factors were similar between the groups. Significantly more patients developed blindness in the 2020 cohort (21.87%) than in the 2021 cohort (7.84%). Patients in the 2020 showed a longer time from symptom to treatment (241.84 ± 211.95 h in 2020 vs. 121.53 ± 96.12 h in 2021; P = 0.001), higher intraocular pressure at presentation (52.63 ± 12.45 mmHg in 2020 vs. 45.16 ± 9.79 mmHg in 2021; P = 0.001), larger pupil diameter (5.47 ± 1.62 mm in 2020 vs. 4.33 ± 1.27 mm in 2021; P = 0.001), and more glaucomatous optic neuropathy diagnoses [20/64 eyes (31.25%) in 2020 vs. 7/51 eyes (13.73%) in 2021; P = 0.03]. Conclusion The time between the onset of APAC symptoms and its treatment during the COVID-19 epidemic lockdown was significantly prolonged, which increased the blindness rate of APAC patients.
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Affiliation(s)
- Li Zhou
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hosptial), Wuhan, China
| | - Shaoqun Wu
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hosptial), Wuhan, China
| | - Yong Wang
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hosptial), Wuhan, China,*Correspondence: Yong Wang ✉
| | - Xianyi Bao
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hosptial), Wuhan, China
| | - Tingting Peng
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hosptial), Wuhan, China
| | - Wenjing Luo
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hosptial), Wuhan, China
| | - Julio Ortega-Usobiaga
- Department of Cataract and Refractive Surgery, Clínica Baviera, Aier Eye Hospital, Bilbao, Spain
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15
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De Silva I, Thomas MG, Shirodkar AL, Kuht HJ, Ku JY, Chaturvedi R, Beer F, Patel R, Rana-Rahman R, Anderson S, Dickerson P, Walsh F, While B, Clarke L, Siriwardena D, Dhawahir-Scala F, Buchan J, Verma S. Patterns of attendances to the hospital emergency eye care service: a multicentre study in England. Eye (Lond) 2022; 36:2304-2311. [PMID: 34845355 PMCID: PMC8629695 DOI: 10.1038/s41433-021-01849-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/09/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND/OBJECTIVES To characterise the patterns of presentation and diagnostic frequencies in Hospital Emergency Eye Care Services (HEECS) across 13 hospitals in England. METHODS Retrospective, cross-sectional, observational multi-centre (n = 13) study to assess HEECS attendances over a 28-day study period. Data derived included: number of consecutive attendances, patient demographics and diagnoses. Age and gender variations, the impact of day of the week on attendance patterns, diagnostic frequencies and estimates of the annual incidence and attendance rates were evaluated. RESULTS A total of 17,667 patient (mean ± standard deviation age = 49.6 ± 21.8 years) attendances were identified with an estimated HEECS annual new attendance rate of 31.0 per 1,000 population. Significantly more females (53%) than males (47%) attended HEECS (p < 0.001). Female attendances were 13% higher in those ≥50 years of age. Weekends were associated with a significant reduction in attendances compared to weekdays (χ2 = 6.94, p < 0.001). Among weekdays, Mondays and Fridays were associated with significantly higher attendances compared with midweek (χ2 = 2.20, p = 0.032). Presenting pathologies involving the external eye, cornea and conjunctiva accounted for 28.6% of the caseload. CONCLUSION This is the largest multicentre study assessing attendance patterns in HEECS in England. We have, for the first time, observed a "weekend effect" in relation to attendance to HEECS. Differences in health-seeking behaviour and lack of awareness of HEECS weekend services may be partly attributed to the differences observed. Our findings, along with the type of presentations, have the potential to guide commissioners with future planning of HEECS.
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Affiliation(s)
- Ian De Silva
- Department of Ophthalmology, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, LE1 5WW, UK.
| | - Mervyn G Thomas
- Department of Ophthalmology, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, LE1 5WW, UK
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, PO Box 65, Leicester, LE2 7LX, UK
| | - Amy-Lee Shirodkar
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK
| | - Helen J Kuht
- Department of Ophthalmology, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, LE1 5WW, UK
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, PO Box 65, Leicester, LE2 7LX, UK
| | - Jae Yee Ku
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK
| | - Ritu Chaturvedi
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - Freddy Beer
- Ophthalmology Department, Queen Alexandra Hospital, Southwick Hill Road, Portsmouth, PO6 3LY, UK
| | - Radhika Patel
- The Victoria Eye Unit, The County Hospital, Union Walk, Hereford, HR1 2ER, UK
| | - Romeela Rana-Rahman
- Eye Department, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Sarah Anderson
- Department of Ophthalmology, York Teaching Hospitals NHS Foundation Trust, Wigginton Road, York, YO31 8HE, UK
| | - Polly Dickerson
- Department of Ophthalmology, Scarborough Hospital, Woodlands Drive, Scarborough, YO12 6QL, UK
| | - Francine Walsh
- Ophthalmology Department, Royal Bolton Hospital, Minerva Road, Bolton, BL4 0JR, UK
| | - Ben While
- The Victoria Eye Unit, The County Hospital, Union Walk, Hereford, HR1 2ER, UK
| | - Lucy Clarke
- Eye Department, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Dilani Siriwardena
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK
| | | | - John Buchan
- International Centre for Eye Health, Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- The Leeds Centre for Ophthalmology, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - Seema Verma
- Eye Department, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
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16
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Hell CL, Deschner J, Cores Ziskoven P, Mildenberger P, Weusmann J. Interplay of pandemic and seasonal parameters in dental emergency service. BMC Oral Health 2022; 22:475. [PMID: 36348347 PMCID: PMC9644011 DOI: 10.1186/s12903-022-02524-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022] Open
Abstract
Background To evaluate the relationship between pandemic events and dental emergency service frequentation. Utilization patterns in the scope of the COVID-19 pandemic were analyzed and considered in regard of seasonal parameters. Methods All outpatients seeking treatment in a university hospital’s dental emergency service were analyzed in the years 2019, 2019 and 2020 according to demographic data and emergencies were subdivided into “absolute” and “relative”. The years 2018 and 2019 were used to compare COVID-19 and non-COVID-19 phases. Defined waves of the pandemic were compared with equivalent prior-year periods. Results Our study includes 11,219 dental emergency patients over a period of three years with a slight surplus of male patients. Comparing the pre-COVID-19 years and 2020 as a year of pandemic, the total count of cases decreased by more than 25%. The share of absolute emergencies in 2020 was higher than in the years before (p < 0.0001). The under-utilization during the waves was more pronounced during the first wave compared to the second waves. Conclusions Additionally to the clear decrease by more than 25% in 2020, we found an inverse dependency of 7-day-incidence of COVID-19 and number of visits. This effect was more distinct for relative emergencies, while the number of patients with absolute emergencies remains rather constant. Probably, there is an acclimatization effect regarding the waves. Patients older than 60 years who suffered from relative emergencies showed an under-utilzation during 2020. During a pandemic such as COVID-19, the effect of under-utilization is more pronounced among elderly patients. However, a pandemic acclimatization effect seems to occur. This can be taken into account in the administration of this kind of circumstances in the future.
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Durmaz Engin C, Ozturk T, Akbulut Yagci B, Ozcelik O, Ecer R. The Impact of the COVID-19 Pandemic on Emergency Department Visits Resulting in Ophthalmology Consultations. Cureus 2022; 14:e30598. [PMID: 36420225 PMCID: PMC9679986 DOI: 10.7759/cureus.30598] [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] [Accepted: 10/21/2022] [Indexed: 05/21/2023] Open
Abstract
Introduction The aim of this study is to determine the characteristics of eye-related emergency department (ED) visits resulting in ophthalmology consultation during the COVID-19 pandemic and compare them against an equivalent period from the previous year. Methods In this study, we reviewed the charts of patients who were admitted to ED with ocular complaints between March 11th, 2020 (the date of the first COVID-positive case in our country) and March 11th, 2021 (Study period 1; SP1) and those who were admitted to ED within the equivalent period of the previous year (Study period 2; SP2). The frequency of eye-related cases, the urgency status of complaints, diagnosis, treatment applied, and hospitalization status of the patients were compared. Results The proportion of ophthalmology consultations among all medical departments decreased from 4.52% to 4.04% (p<0.001). There was a 40.5% reduction in eye-related ED admissions during the pandemic, and the top three ocular diagnoses were foreign bodies of the ocular surface (24.3%), corneal abrasion (18.7%), and blow-out fractures (6.2%) during SP1. The proportion of urgent eye-related emergency visits increased during the pandemic year (80.7% of total cases) compared to the year prior to the pandemic (66.0% of total cases) (p<0.001). Although the number of ophthalmology consultations per day decreased during lockdown periods, this decrease was not statistically significant. Conclusion During the first year of the COVID-19 pandemic, the number of eye-related ED visits decreased in comparison to the year which preceded the pandemic. However, the proportion of urgent visits increased during the pandemic. Understanding the circumstances under which patients seek eye care in EDs is critical to rendering the optimal level of service of available resources.
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Affiliation(s)
- Ceren Durmaz Engin
- Department of Ophthalmology, Karadeniz Eregli State Hospital, Zonguldak, TUR
| | - Taylan Ozturk
- Department of Ophthalmology, Dokuz Eylul University, Izmir, TUR
| | | | - Oguzhan Ozcelik
- Department of Ophthalmology, Dokuz Eylul University, Izmir, TUR
| | - Resul Ecer
- Department of Emergency Medicine, Dokuz Eylul University, Izmir, TUR
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18
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Liang H, Zhang M, Chen M, Lin TPH, Lai M, Chen H. Ocular Trauma During COVID-19 Pandemic: A Systematic Review and Meta-analysis. Asia Pac J Ophthalmol (Phila) 2022; 11:481-487. [PMID: 36094376 DOI: 10.1097/apo.0000000000000539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/19/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study aimed to summarize the latest literature on the trends and incidence of ocular trauma during the COVID-19 pandemic. DESIGN Systematic review and meta-analysis. METHODS A systematic literature search was conducted to identify the relevant literature. The search period was between January 1, 2020, and September 20, 2021. The incidence of overall and various types of ocular trauma during the COVID-19 pandemic and the control period was analyzed. The data from different studies were pooled. The odds ratio (OR) and 95% confidence interval (CI) were calculated. RESULTS A total of 32 articles were included. After pooling the data from all included studies, the incidence of total and pediatric ocular trauma during the COVID-19 pandemic was 67.7% and 54.3% of those in the control period, respectively. However, the proportion of ocular trauma in eye emergency visits increased during the pandemic (OR, 95% CI: 1.46, 1.04-2.06). The proportion of domestic ocular trauma increased (OR, 95% CI: 3.42, 1.01-11.62), while ocular trauma related to sports and outdoor activities and occupational ocular trauma decreased (OR, 95% CI: 0.64, 0.09-4.29 and 0.18, 0.10-0.33, respectively). It was also reported that chemical injury caused by alcohol-based sanitizers, photokeratitis caused by ultraviolet lamps, and mechanical eye injury caused by masks increased during the COVID-19 pandemic. CONCLUSIONS There was a reduction in overall eye injuries and substantial differences in the spectrum of ocular trauma during the COVID-19 pandemic. Proper health education and supervision should be strengthened to prevent ocular injuries related to COVID-19 preventive interventions.
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Affiliation(s)
- Huiyu Liang
- Joint Shantou International Eye Center, Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Meiqin Zhang
- Joint Shantou International Eye Center, Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Man Chen
- Joint Shantou International Eye Center, Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Timothy P H Lin
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Mingying Lai
- Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Haoyu Chen
- Joint Shantou International Eye Center, Shantou University and The Chinese University of Hong Kong, Shantou, China
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19
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Przybek-Skrzypecka J, Szewczuk A, Kamińska A, Skrzypecki J, Pyziak-Skupień A, Szaflik JP. Effect of COVID-19 Lockdowns on Eye Emergency Department, Increasing Prevalence of Uveitis and Optic Neuritis in the COVID-19 Era. Healthcare (Basel) 2022; 10:healthcare10081422. [PMID: 36011079 PMCID: PMC9408570 DOI: 10.3390/healthcare10081422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The COVID-19 pandemic led to the reorganization of the health care system. A decline in health- and life-saving procedures has been reported in various medical specialties. However, data on ophthalmic emergencies during lockdowns is limited. Methods: We conducted a retrospective, observational, case-control study of 2351 patients registered at the ophthalmic emergency department of a tertiary hospital in Poland during three national COVID-19 lockdowns (March/April 2020, November 2020, and March/April 2021) and corresponding months in 2019. Results: The total number of visits declined from a mean of 720/month in the non-COVID era to 304/month during COVID-19 lockdowns (p < 0.001). Ocular trauma incidence dropped significantly from 2019 (non-COVID months) to 2020/2021 (COVID group mean 201 vs. 97 patients monthly, respectively, p = 0.03). Of note, the percentage of foreign bodies removal was significantly higher during lockdowns than corresponding time in the non-COVID era. A downward trend for vitreous detachment and macular disorders cases was observed between COVID and non-COVID time. Uveitis and optic neuritis patients were seen more often during lockdowns (p < 0.001 and p = 0.0013, respectively). In contrast, the frequency of conjunctivitis and keratitis, potentially COVID-related problems, decreased significantly in COVID-19 time (mean 138 vs. 23 per month in non-COVID vs. COVID lockdowns, respectively, p < 0.001). Conclusions: The overall number of eye emergency visits declined during COVID-19 lockdowns. Conjunctivitis and keratitis rates dropped during the lockdowns. Interestingly, the frequency of immune-mediated ocular conditions (uveitis, optic neuritis) increased significantly which might be triggered by SARS-CoV2 infection.
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Affiliation(s)
- Joanna Przybek-Skrzypecka
- Department of Ophthalmology, The Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland; (A.K.); (J.P.S.)
- SPKSO Ophthalmic University Hospital, 24/26 Marszałkowska Street, 00-576 Warsaw, Poland; (A.S.); (J.S.)
- Correspondence:
| | - Alina Szewczuk
- SPKSO Ophthalmic University Hospital, 24/26 Marszałkowska Street, 00-576 Warsaw, Poland; (A.S.); (J.S.)
| | - Anna Kamińska
- Department of Ophthalmology, The Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland; (A.K.); (J.P.S.)
- SPKSO Ophthalmic University Hospital, 24/26 Marszałkowska Street, 00-576 Warsaw, Poland; (A.S.); (J.S.)
| | - Janusz Skrzypecki
- SPKSO Ophthalmic University Hospital, 24/26 Marszałkowska Street, 00-576 Warsaw, Poland; (A.S.); (J.S.)
- Department of Experimental Physiology and Pathophysiology, The Medical University of Warsaw, 3C Pawińskiego Street, 02-106 Warsaw, Poland
| | - Aleksandra Pyziak-Skupień
- Department of Children’s Diabetology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 16 Medyków Street, 40-752 Katowice, Poland;
| | - Jacek Paweł Szaflik
- Department of Ophthalmology, The Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland; (A.K.); (J.P.S.)
- SPKSO Ophthalmic University Hospital, 24/26 Marszałkowska Street, 00-576 Warsaw, Poland; (A.S.); (J.S.)
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20
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Hurley DJ, Neary S. An analysis of the conditions referred to an eye emergency department. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2079496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Daire J Hurley
- Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Dublin, Ireland
| | - Simon Neary
- Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Dublin, Ireland
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21
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Durouchoux A, Liguoro D, Sesay M, Le Petit L, Jecko V. Subarachnoid space of the optic nerve sheath and intracranial hypertension: a macroscopic, light and electron microscopic study. Surg Radiol Anat 2022; 44:759-766. [PMID: 35507023 DOI: 10.1007/s00276-022-02948-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/14/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The optic nerve (ON) is an extension of the central nervous system via the optic canal to the orbital cavity. It is accompanied by meninges whose arachnoid layer is in continuity with that of the chiasmatic cistern. This arachnoid layer is extended along the ON, delimiting a subarachnoid space (SAS) around the ON. Not all forms of chronic intracranial hypertension (ICH) present papilledema. The latter is sometimes asymmetric, unilateral, or absent. The radiological signs of optic nerve sheath (ONS) dilation, in magnetic resonance imaging, are inconsistent or difficult to interpret. The objective of this study was to analyze the anatomy, the constitution, and the variability of the SAS around the ON in its intraorbital segment to improve the understanding of the pathophysiologic mechanism of asymmetric or unilateral or absent papilledema in certain ICH. METHODS The study was carried out on nine cadaveric specimens. In four embalmed specimens, macroscopic analysis of the SAS of the ONS were performed, with description about density of the arachnoid trabecular meshwork in three distinct areas (bulbar segment, mid-orbital segment and the precanal segment). In three other embalmed specimens, after staining of SAS by methylene blue (MB), we performed macroscopic analysis of MB progression in the SAS of the ONS. Then, in two non-embalmed specimens, light and electron microscopy (EM) analysis were also done. RESULTS On the macroscopic level, after staining of SAS, we found in all cases that MB progressed on 16 mm average throughout the SAS of the ONS without reaching the papilla. In four embalmed specimens, in the SAS of the ONS, the density of the arachnoid trabecular meshwork showed inter-individual variability (100%) and intra-individual variability with bilateral variability (50%) and/or variability within the same ONS (88%). On the microscopic level, the arachnoid trabeculae of the ONS are composed of dense connective tissue. The EM perfectly depicted its composition which is mainly of collagen fibers of parallel orientation. CONCLUSION The variability of the SAS around the ONS probably impacts the symmetrical or asymmetrical nature of papilledema in ICH.
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Affiliation(s)
- A Durouchoux
- Neurosurgery B Department, University Hospital Bordeaux, Bordeaux, France.
| | - D Liguoro
- Neurosurgery A Department, Bordeaux Hospital, Bordeaux, France.,Department of Anatomy, University of Bordeaux, Bordeaux, France
| | - M Sesay
- Neuroanesthesia, Bordeaux Hospital, Bordeaux, France
| | - L Le Petit
- Neurosurgery A Department, Bordeaux Hospital, Bordeaux, France
| | - V Jecko
- Neurosurgery A Department, Bordeaux Hospital, Bordeaux, France
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22
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Mundae R, Velez A, Sodhi GS, Belin PJ, Kohler JM, Ryan EH, Tang PH. Trends in the Clinical Presentation of Primary Rhegmatogenous Retinal Detachments During the First Year of the COVID-19 Pandemic. Am J Ophthalmol 2022; 237:49-57. [PMID: 34801509 PMCID: PMC8603252 DOI: 10.1016/j.ajo.2021.11.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/02/2021] [Accepted: 11/09/2021] [Indexed: 11/26/2022]
Abstract
Purpose To evaluate the effect of 1 full year of the coronavirus disease 2019 (COVID-19) pandemic on clinical presentation of acute, primary rhegmatogenous retinal detachment (RRD). Design Single-center, retrospective observational cohort study. Methods Patients were divided into 2 cohorts: consecutive patients treated for primary RRD during the COVID-19 pandemic (March 9, 2020, to March 7, 2021; pandemic cohort) and patients treated during the corresponding time in previous year (March 11, 2019, to March 8, 2020; control cohort). Main outcome measures: Proportion of patients presenting with macula-involving (mac-off) or macula-sparring (mac-on) RRD. Results A total of 952 patients in the pandemic cohort and 872 patients in the control cohort were included. Demographic factors were similar. Compared with the control cohort, a significantly greater number of pandemic cohort patients presented with mac-off RRDs ([60.92%] pandemic, [48.17%] control, P = .0001) and primary proliferative vitreoretinopathy ([15.53%] pandemic, [6.9%] control, P = .0001). Pandemic cohort patients (10.81%) had significantly higher rates of lost to follow-up compared with the control cohort (4.43%; P = .0001). Patients new to our clinic demonstrated a significant increase in mac-off RRDs in the pandemic cohort (65.35%) compared with the control cohort (50.40%; P = .0001). Pandemic cohort patients showed worse median final best-corrected visual acuity (0.30 logarithm of the minimum angle of resolution) compared with the control cohort (0.18 logarithm of the minimum angle of resolution; P = .0001). Conclusions Patients with primary RRD during the first year of the COVID-19 pandemic were more likely to have mac-off disease, present with primary proliferative vitreoretinopathy, be lost to follow-up, and have worse final best-corrected visual acuity outcomes.
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23
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The impact of COVID-19 on traumatic eye emergencies needing surgery. Eye (Lond) 2022; 36:899-900. [PMID: 33958738 PMCID: PMC8100749 DOI: 10.1038/s41433-021-01565-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 03/28/2021] [Accepted: 04/15/2021] [Indexed: 02/02/2023] Open
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24
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COVID-19 pandemic decreased the ophthalmic outpatient numbers and altered the diagnosis distribution in a community hospital in Taiwan: An observational study. PLoS One 2022; 17:e0264976. [PMID: 35259188 PMCID: PMC8903288 DOI: 10.1371/journal.pone.0264976] [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: 09/25/2021] [Accepted: 02/19/2022] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to determine the effect of Coronavirus disease 2019 (COVID-19) pandemic on ophthalmic outpatient numbers and ophthalmic diagnosis distribution in a community hospital (Taipei City Hospital Zhongxiao Branch) in Taiwan. The COVID-19 pandemic period in Taiwan was defined as May 1 to July 31, 2021. Demographic data, including age, gender, and top 10 diagnoses from ophthalmic outpatients during this period, were collected. A corresponding control group from the same time in 2020 was also collected. The distribution of different diagnoses was analyzed, and the data of 10 most prominent diagnoses with decreased percentage of case numbers during the COVID-19 pandemic period were obtained. The number of cases during the COVID-19 pandemic decreased by 46.9% compared to the control group. The top three most common diagnoses were dry eye syndrome, glaucoma, and macular diseases. The 10 most prominent diagnoses with decreased number of cases during the COVID-19 pandemic were cataract, refraction & accommodation, macular degeneration, conjunctivitis, retinal detachment, vitreous body disorders, ophthalmic complications of diabetes mellitus, glaucoma, dry eye, and retinal vein occlusion. Identifying and treating these patients as scheduled may yield the highest cost-benefit effect in preventing visual loss during the COVID-19 pandemic.
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25
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Patel PA, Gopali R, Reddy A, Patel KK. Baseball-related ocular injuries in the United States: a 10-year analysis. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2039629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Parth A. Patel
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Rhea Gopali
- North Carolina State University, Raleigh, NC 27695, USA
| | | | - Kajol K. Patel
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
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26
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Leung KFC, Golzan M, Egodage C, Rodda S, Cracknell R, Macken P, Kaushik S. Impact of COVID-19 pandemic on ophthalmic presentations to an Australian outer metropolitan and rural emergency department: a retrospective comparative study. BMC Ophthalmol 2022; 22:40. [PMID: 35090415 PMCID: PMC8796873 DOI: 10.1186/s12886-022-02271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/24/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To analyse ophthalmic presentations to an outer metropolitan and a rural emergency department (ED) during the first wave of the COVID-19 pandemic in New South Wales (NSW), Australia.
Methods
A retrospective comparative study of ophthalmic emergency presentations to Campbelltown Hospital (fifth busiest NSW metropolitan ED; population 310,000) and Bowral and District Hospital (rural ED; population 48,000) before and during COVID-19 was conducted. Patient demographics, triage category, referral source, diagnosis, length of stay, departure status, and follow-up location were assessed from coding data between March 1st to May 31st in 2019 and 2020, corresponding to the peak case numbers and restrictions during the first wave of the COVID-19 pandemic in NSW. Differences before and during COVID-19 were analysed using chi-squared tests or independent sample t-tests.
Results
There was no change in ophthalmic presentations at Campbelltown (n = 228 in 2019 vs. n = 232 in 2020; + 1.75%, p = 0.12) and an increase at Bowral (n = 100 in 2019 vs. n = 111 in 2020; + 11%, p < 0.01) during COVID-19. Urgent ophthalmic presentations (Triage Category 3) decreased at Bowral (p = 0.0075), while non-urgent ophthalmic presentations (Triage Category 5) increased at both hospitals (Campbelltown p < 0.05, Bowral p < 0.01).
Conclusions
There was no change in the total number of ophthalmic presentations to an outer metropolitan and an increase to a rural ED during the first wave of the COVID-19 pandemic in New South Wales, Australia. A change in the type of ophthalmic presentations at these peripheral EDs suggest that a high demand for ophthalmic services remained despite the pandemic and its associated gathering and movement restrictions. A flexible healthcare delivery strategy, such as tele-ophthalmology, may optimise patient care during and after COVID-19.
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27
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Yu H, Xu M, Zhao Y, Li J, Wu W, Feng Y. COVID-19 Changed Prevalence, Disease Spectrum and Management Strategies of Ocular Trauma. Front Med (Lausanne) 2022; 8:774493. [PMID: 35083239 PMCID: PMC8784966 DOI: 10.3389/fmed.2021.774493] [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: 09/12/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the health of people around the world and has reshaped social behaviors and clinical practice. The purpose of this perspective is to provide epidemiologists and clinicians with information about how the spectrum of ocular trauma diseases changed, as well as to optimize management for improving patient prognosis during this crisis. Analysis of current studies revealed that the prevalence of eye trauma decreased overall, with a trend of delayed medical treatment during the COVID-19 era. Irregular epidemic prevention and control measures, unprotected home activities, and unusual mental states are the main causes of ocular trauma. Strategies for reducing morbidity are also discussed, including popularizing the use norms of prevention and control supplies, taking heed to the safety of family activities, highlighting the special status of child protection, and paying attention to previous case data to implement region-specific precautions. The procedure of ophthalmological emergency and outpatient management should also be optimized, and mental health should be emphasized during this pandemic.
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Affiliation(s)
- Haozhe Yu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Minhui Xu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Yue Zhao
- Institute of Medical Education, Peking University, Beijing, China
| | - Jingyi Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Wenyu Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Yun Feng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
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28
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Akbas E, Korkmaz I, Palamar M, Barut Selver O. Shifting trends in demographic features of chemical eye injuries during COVID-19 pandemic. Int Ophthalmol 2022; 42:2127-2132. [PMID: 35013832 PMCID: PMC8745549 DOI: 10.1007/s10792-022-02211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/01/2022] [Indexed: 11/25/2022]
Abstract
Objectives To evaluate the etiological cause distribution in chemical eye injuries during COVID-19 pandemic. Methods In this retrospective case series, the medical records of patients, who presented with chemical eye injuries between March 30, 2020, and March 1, 2021, were evaluated and compared with the data covering 10 years before the pandemic. Results Twenty-seven eyes of twenty-three patients (19 adults, 4 children) who presented in pandemic period were included. Alcohol-based hand sanitizer was one of the two most common agents (n = 6 eyes) in the pandemic era. In the last 10 years before the pandemic, 137 eyes of 102 patients were treated for chemical eye injuries. Injuries due to alcohol-based hand sanitizer increased from 3.1 to 21.1% among all patients, and from 0 to 75% among pediatric patients during the pandemic era compared to the pre-pandemic period. The increase was statistically significant both in all patients (p = .003) and in the pediatric patient group (p = .048). Conclusion Due to COVID-19 pandemic, alcohol-based hand sanitizer use became more common. Consequently, the frequency of hand sanitizer related chemical injuries showed a 13-fold increase and the age group affected by such accidents is altered during the pandemic. Three out of four pediatric patients (75%) were injured with alcohol-based hand sanitizers, which draws attention to the fact that improperly placed hand sanitizer stations, being just at the eye level of children, can cause chemical eye injuries in the pediatric population even more.
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Affiliation(s)
- Elif Akbas
- Faculty of Medicine, Department of Ophthalmology, Ege University, 35040, Izmir Bornova, Turkey
| | - Ilayda Korkmaz
- Faculty of Medicine, Department of Ophthalmology, Ege University, 35040, Izmir Bornova, Turkey
| | - Melis Palamar
- Faculty of Medicine, Department of Ophthalmology, Ege University, 35040, Izmir Bornova, Turkey
| | - Ozlem Barut Selver
- Faculty of Medicine, Department of Ophthalmology, Ege University, 35040, Izmir Bornova, Turkey.
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29
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Hakim N, Longmore P, Hu VH. Patient Experience Survey in a Corneal Service Conducted by Remote Consultation. Clin Ophthalmol 2022; 15:4747-4754. [PMID: 34983998 PMCID: PMC8699778 DOI: 10.2147/opth.s331622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 09/07/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction An ophthalmic remote consultation clinic was implemented due to the COVID-19 pandemic for stable patients under the corneal service in a district general hospital in Cheshire, UK. Patients were reviewed either by video or telephone consultation. The purpose of this survey was to assess patient satisfaction with this service. Methods Consecutive patients who were seen by remote consultation between September 2020 and November 2020 were identified. Approval for the survey was gained from the hospital Patient Experience and Survey department. A telephone survey was conducted between 4 and 8 weeks after the initial patient appointment. Data were obtained for patient demographic information, appointment details and patient satisfaction with their appointment, including preference for subsequent appointments and open feedback. Results Eighty-four remote consultations were identified and 51 (60.7%) patients completed the survey: 48 (94.1%) reported satisfaction with their remote consultation; 36 (70.5%) reported satisfaction for a subsequent remote consultation; and 33 (64.7%) patients reported they preferred being seen remotely rather than face-to-face. Qualitative data on patients’ thoughts about the service could be categorised into 4 themes: satisfaction with the interaction and service, conveniency, lack of clinical examination and satisfaction with the service given the current pandemic circumstances. Conclusion This survey has shown that patients were satisfied with their remote consultation and the majority thought it was an acceptable method of consultation. This also allowed patients to continue being seen during a period of COVID-19 lockdown and reduce patient footfall through the hospital. Overall feedback indicated very high levels of patient satisfaction with this service.
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Affiliation(s)
- Navid Hakim
- Eye Department, Mid Cheshire NHS Hospitals Foundation Trust, Crewe, UK
| | - Philippa Longmore
- Eye Department, Mid Cheshire NHS Hospitals Foundation Trust, Crewe, UK
| | - Victor H Hu
- Eye Department, Mid Cheshire NHS Hospitals Foundation Trust, Crewe, UK.,International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
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30
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Invernizzi A. The impact of COVID-19 on the retina: clinical features and management considerations. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2021877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Sciences L. Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
- The Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, Save Sight Institute, Sydney Eye Hospital, The University of Sydney, Sydney, Australia
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31
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Sabetkish N, Rahmani A. The overall impact of COVID-19 on healthcare during the pandemic: A multidisciplinary point of view. Health Sci Rep 2021; 4:e386. [PMID: 34622020 PMCID: PMC8485600 DOI: 10.1002/hsr2.386] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/21/2021] [Accepted: 08/22/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS The Coronavirus disease 2019 (COVID-19) pandemic globally changed the priorities of medical and surgical procedures. It has caused many healthcare systems to stop performing their routine screenings. Altering medical clinics to COVID-19 referral centers, lockdowns, and the public fear to refer to medical centers caused a significant reduction in the referral rate; especially in the elderly. This short review article highlights the transform in clinical practice during the post-COVID era and the need for future medical revolutions. METHODS A comprehensive literature search was separately performed by both authors. The articles published between 2019 and August 2021 were included in this study and selected according to a quality appraisal method. RESULTS We have summarized the possible corresponding changes in the diagnosis and treatment of all fields of medical care including internal medicine, surgical, and minor subcategories after the COVID-19 pandemic. We have also discussed the potential impacts of the pandemic on all these different categories and subcategories of medicine, including the outpatient setting and clinical work. We do believe that the lack of routine check-ups has led to an increase in the stage of disease in patients with a previously diagnosed problem. On the other hand, the dramatic change in the lifestyle of the population including restricted mobility and increased consumption of unhealthy food has caused metabolic syndrome and other new diseases that have not been diagnosed and properly managed. CONCLUSION Our findings revealed the urgent need for public health awareness. It indicated the need to carry out both psychological and screening approaches in the post-COVID era to not miss patients with a chronic disease and new cases who were undiagnosed during the COVID pandemic.
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Affiliation(s)
- Nastaran Sabetkish
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical CenterTehran University of Medical SciencesTehranIran
- ImmunologyAsthma and Allergy Research Institute, Tehran University of Medical SciencesTehranIran
| | - Alireza Rahmani
- Research Center for Prevention of Cardiovascular DiseaseInstitute of Endocrinology & Metabolism, Iran University of Medical SciencesTehranIran
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32
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Puzo M, Sánchez-Monroy J, Porcar-Plana CA, Bartol-Puyal FDA, Dotti-Boada M, Peña-Urbina P, Izquierdo-Serra J, López-Montero A, Pérez-García P, Bordonaba-Bosque D, Pablo LE, Calvo P. Ocular related emergencies in Spain during the COVID-19 pandemic, a multicenter study. BMC Ophthalmol 2021; 21:408. [PMID: 34837985 PMCID: PMC8626758 DOI: 10.1186/s12886-021-02169-x] [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: 03/17/2021] [Accepted: 10/20/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To evaluate ophthalmological emergencies (OE) during the COVID-19 pandemic comparing them with the same period of the previous year. METHODS Retrospective observational study of all OE visits in four tertiary hospitals in Spain comparing data from March 16th to April 30th, 2020 (COVID-19 period) and the same period of 2019 (pre-COVID-19 period). Severity of the conditions was assessed following Channa et al. publication. Data on demographics, diagnosis and treatments were collected from Electronic Medical Records. RESULTS During lockdown, OE significantly declined by 75.18%, from 7,730 registered in the pre-COVID-19 period to 1,928 attended during the COVID-19 period (p < 0.001). In 2019, 23.86% of visits were classified as emergent, 59.50% as non-emergent, and 16.65% could not be determined. In 2020, the percentage of emergent visits increased up to 29.77%, non-emergent visits significantly decreased to 52.92% (p < 0.001), and 17.31% of the visits were classified as "could not determine". During the pandemic, people aged between 45 and 65 years old represented the largest attending group (37.89%), compared to 2019, where patients over 65 years were the majority (39.80%). In 2019, most frequent diagnosis was unspecified acute conjunctivitis (11.59%), followed by vitreous degeneration (6.47%), and punctate keratitis (5.86%). During the COVID-19 period, vitreous degeneration was the first cause for consultation (9.28%), followed by unspecified acute conjunctivitis (5.63%) and punctate keratitis (5.85%). CONCLUSIONS OE visits dropped significantly during the pandemic in Spain (75.18%), although more than half were classified as non-urgent conditions, indicating a lack of understanding of the really emergent ocular pathologies among population.
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Affiliation(s)
- Martín Puzo
- Ophthalmology Department, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain. .,Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain.
| | - Jorge Sánchez-Monroy
- Ophthalmology Department, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain
| | | | - Francisco de Asís Bartol-Puyal
- Ophthalmology Department, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | | | - Pilar Peña-Urbina
- Ophthalmology Department, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Ana López-Montero
- Ophthalmology Department, Hospital Clínico Universitario, Valencia, Spain
| | | | | | - Luis E Pablo
- Ophthalmology Department, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | - Pilar Calvo
- Ophthalmology Department, Miguel Servet University Hospital, Paseo Isabel la Católica 1-3, 50009, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Aragón Institute for Health Research (IIS-Aragón), Zaragoza, Spain
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González-Martín-Moro J, Guzmán-Almagro E, Izquierdo Rodríguez C, Fernández Hortelano A, Lozano Escobar I, Gómez Sanz F, Contreras I. Impact of the COVID-19 Lockdown on Ophthalmological Assistance in the Emergency Department at a Spanish Primary Level Hospital. J Ophthalmol 2021; 2021:8023361. [PMID: 34840824 PMCID: PMC8616649 DOI: 10.1155/2021/8023361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To analyze the changes in ophthalmological emergencies during the COVID-19 pandemic lockdown at a Spanish primary level hospital. METHODS The number and type of emergencies attended in the emergency department of Hospital Universitario del Henares between March 10 and August 31, 2020 (COVID-19 cohort) were compared with the emergencies attended during the same period of 2019 (pre-COVID-19 cohort). Data on the diagnosis, patient age, and gender was retrospectively collected from the electronic medical records of the hospital. The different diagnoses were organized into "clusters," which include those conditions that affect the same ocular tissue and that have similar clinical expression. RESULTS The number of ophthalmological emergencies during the study period was 841, compared to 1343 during the same month of 2019, which represents a reduction of 37.4%. The percentage reduction in each cluster was as follows: conjunctiva (-65.4%), cornea (-35.8%), uveitis (-3.6%), eyelid and orbital and lacrimal (-35.5%), strabismus (-60%), neuro-ophthalmology (-11.8%), retina (-10.6%), cataract (+16.4%), glaucoma (-37%), and miscellaneous (-45.1%). The number of people seen with viral conjunctivitis decreased by -87.1% compared to 2019. Patients with complications due to conjunctivitis also decreased: patients with pseudomembranes dropped from 16 to 4 cases and patients with corneal subepithelial infiltrates from 9 to 3 cases. CONCLUSIONS Most diagnostic clusters showed a similar decrease. Clusters that included vision-threating conditions (retina, neuro-ophthalmology, and uveitis) remained mostly stable. During the COVID-19 lockdown, the diagnosis of adenoviral conjunctivitis decreased nearly 10 times. This fact may represent a decrease in the transmission of these infections.
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Affiliation(s)
- Julio González-Martín-Moro
- Department of Ophthalmology, Hospital Universitario del Henares, Madrid, Spain
- Department of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | | | | | | | - Fernando Gómez Sanz
- Department of Ophthalmology, Hospital Universitario del Henares, Madrid, Spain
- Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Inés Contreras
- Department of Ophthalmology, University Hospital Ramón y Cajal, Madrid, Spain
- Clínica Rementería, Madrid, Spain
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Butt GF, Hodson J, Wallace GR, Rauz S, Murray PI. Public perceptions of eye symptoms and hospital services during the first UK lockdown of the COVID-19 pandemic: a web survey study. BMJ Open Ophthalmol 2021; 6:e000854. [PMID: 34693022 PMCID: PMC8520595 DOI: 10.1136/bmjophth-2021-000854] [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: 07/14/2021] [Accepted: 10/05/2021] [Indexed: 11/15/2022] Open
Abstract
Objective This study aimed to explore the British public’s healthcare-seeking beliefs concerning eye symptoms, and assess how the first COVID-19 lockdown influenced these. Methods and analysis An anonymous web-based survey was disseminated through mailing lists and social media between June and August 2020. The survey sought participants’ views on the severity and urgency of the need for medical review for four ophthalmic and two general medical scenarios on a five-point scale. Participants were asked to answer questions twice: once ignoring the COVID-19 pandemic, and once taking this into account, with additional questions asked to identify factors influencing the decision to seek medical attention and ward admission. Results A total of 402 participants completed the survey (mean age 61.6 years, 63.1% female and 87.7% of white ethnicity). Scores for symptom severity and urgency of medical review increased significantly with the severity of the clinical scenario (both p<0.001). However, participants gave significantly lower scores for the urgency of medical attention when accounting for the COVID-19 pandemic (compared with no pandemic) for all scenarios (all p<0.001). Younger age, greater deprivation and non-white ethnicity were correlated with a lower perception of seriousness and urgency of medical attention. Conclusions During the first UK lockdown of the COVID-19 pandemic, reduced urgency of medical review for ocular and systemic pathologies was reported in response to the pandemic, which represents a barrier to healthcare-seeking behaviour. This has the potential to critically delay medical review and timely management, negatively impacting patient outcomes.
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Affiliation(s)
- Gibran F Butt
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - James Hodson
- Medical Statistics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Graham R Wallace
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Saaeha Rauz
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,Ophthalmology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Philip I Murray
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
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Dmuchowska D, Cwalina I, Krasnicki P, Konopinska J, Saeed E, Mariak Z, Obuchowska I. The Impact of Three Waves of the COVID-19 Pandemic on the Characteristics of Primary Rhegmatogenous Retinal Detachments at a Tertiary Referral Centre. Clin Ophthalmol 2021; 15:3481-3491. [PMID: 34429580 PMCID: PMC8378894 DOI: 10.2147/opth.s323998] [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] [Received: 06/09/2021] [Accepted: 07/26/2021] [Indexed: 01/10/2023] Open
Abstract
Purpose This study assessed the effect of three waves of the COVID-19 pandemic primarily on the number and timing of referrals due to rhegmatogenous retinal detachment (RRD) and secondarily on the demographic or clinical characteristics of patients. Patients and Methods A retrospective single-centre analysis of medical records included 247 eyes from 247 patients who underwent primary RRD repair with (phaco) vitrectomy between January 1, 2019, and May 31, 2021. Results The percentage of referrals due to primary RRD during the first year of pandemic (March 2020–February 2021) was 16.5% (p=0.179) lower than a year earlier. The percentage of referrals during the first, second and third wave of the pandemic was 48.4%, 18.5% and 26.1% (p=0.029, 0.475, 0.343) lower than in the corresponding months of 2019. A rebound effect was observed only after the first wave. The numbers of referrals in April and May 2021 were similar as in the corresponding months of 2019. No significant differences were observed in the demographic and clinical characteristics of patients admitted before and during the COVID-19 pandemic, other than a tendency towards a higher representation of women, younger persons, longer duration of symptoms but better visual acuity in the latter group. Silicone oil tamponade was used more frequently during the pandemic than before. Conclusion In this study, the COVID-19 pandemic affected the number and timing of referrals due to RRD and the clinical but not demographic characteristics of the patients. The effect lessened with the duration of the pandemic. Previously raised concerns regarding the delay in RRD referrals may no longer be valid during a potential fourth wave of the pandemic. The impact of the pandemic’s waves should be analysed separately, as such an approach provides a better insight into the fluctuations in the number of referrals due to RRD than a year-to-year comparison.
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Affiliation(s)
- Diana Dmuchowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Izabela Cwalina
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Pawel Krasnicki
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Joanna Konopinska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Emil Saeed
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Zofia Mariak
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Iwona Obuchowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
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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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Franzolin E, Longo R, Casati S, Ceruti P, Marchini G. Influence of the COVID-19 Pandemic on Admissions for Retinal Detachment in a Tertiary Eye Emergency Department. Clin Ophthalmol 2021; 15:2127-2131. [PMID: 34054291 PMCID: PMC8149301 DOI: 10.2147/opth.s307407] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/12/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the incidence and clinical characteristics of retinal detachments (RDs) diagnosed in a tertiary eye emergency department (EED) during the COVID-19 pandemic and in the corresponding period of the previous 4 years. Methods EED consultations performed from February 21, 2020 (first national case of COVID-19 infection) to May 3, 2020 (end of lockdown imposed by national Government) and for the same date range of 2016–2019 (pre-COVID-19 period), and with a confirmed diagnosis of RD were collected and reviewed. The following demographical and clinical features have been analyzed: age, gender, etiology of RD, macular involvement, best corrected visual acuity (BCVA), and duration of experienced symptoms. Results Eighty-two subjects (20.5±1.0 eyes/year) were diagnosed with RD in the pre-COVID-19 period, compared to 12 patients in the COVID-19 period (−41.5%). During the pandemic, patients complained symptoms for a median of 8.5 days (IQR, 1.7–15 days) before the EED consultation, while in the pre-COVID-19 period, they declared they had been symptomatic for 2 days (IQR, 1–4 days) (p=0.037); macula-off RD raised from 56% to 75% and no one reported trauma as a triggering event. Conclusion During the COVID-19 pandemic, the rate of RD diagnosed in our EED decreased significantly and patients waited longer before asking for an ophthalmologic examination. These findings are probably due to the fear of contracting the COVID-19 infection attending hospital environments. Even if emergency departments are often misused by people suffering non-urgent conditions, patients complaining of sudden visual loss, visual field defects, or phosphenes should always and promptly attend an EED visit to prevent a worse prognosis.
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Affiliation(s)
- Elia Franzolin
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Rosa Longo
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefano Casati
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Piero Ceruti
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giorgio Marchini
- Ophthalmic Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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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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Akova B, Kıvanç SA. Ophthalmic Emergencies and Effects of Different Quarantine Models During the COVID-19 Pandemic. Med Sci Monit 2021; 27:e931967. [PMID: 33980807 PMCID: PMC8130502 DOI: 10.12659/msm.931967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background The aim of this study was to evaluate the epidemiological features of the patients admitted to our emergency department (ED) during the COVID-19 pandemic in March, April, and May 2020, compare them with the patients in March, April, and May 2019, and to investigate the effect of various quarantine models. Material/Methods The records of 1206 eligible patients were reviewed. Age groups were divided according to their quarantine status. We recorded the reasons for patient presentation to the ED, the average number of patients in age groups according to quarantine days, and the problems reported by patients who presented to the ED according to quarantine days. Results We enrolled 3016 of 3123 patients. The mean age was 36.4±17.3 years in 2019 and 37.8±16.4 years during the pandemic period (P=0.031). While 73.1% of the ED presentations were due to ocular trauma in 2019, it decreased to 70.7% in 2020. The proportion of those who presented to the ED during the weekend was 30.6% in 2019, but decreased to 23.9% in 2020 (<0.001). While 84.8% of trauma patients were ages 19–64 years in 2019, this rate increased to 88.9% during the pandemic (P=0.067). Non-trauma emergencies were more common than trauma emergencies in both periods in those over the age of 65 years. During the pandemic period, admissions to the ED were decreased in the quarantined age groups (P=0.001). Conclusions The changes in the number and characteristic of admissions for ophthalmic emergencies during the pandemic period may help planning allocation of healthcare personnel and resources in outpatient and emergency clinics.
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Affiliation(s)
- Berna Akova
- Department of Ophthalmology, Bursa Uludağ University, School of Medicine, Bursa, Turkey
| | - Sertaç Argun Kıvanç
- Department of Ophthalmology, Bursa Uludağ University, School of Medicine, Bursa, Turkey
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40
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Tsaousis KT, Chaloulis S. The yearly impact of COVID-19 pandemic on emergency ophthalmic care at a secondary center. Am J Emerg Med 2021; 53:260-261. [PMID: 33902961 PMCID: PMC8057927 DOI: 10.1016/j.ajem.2021.04.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 11/29/2022] Open
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Prabhakar H. Twenty-one Days of Solitude. Indian J Crit Care Med 2021; 25:249-250. [PMID: 33790499 PMCID: PMC7991768 DOI: 10.5005/jp-journals-10071-23757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
As the world is now gradually coming out of the "lockdown" phase, one can expect a change in the demographics and epidemiology of trauma. With traffic back on roads and shifting life again towards "normalcy", it is imperative to carry out introspection and see how we can stop trauma from reaching its pre-COVID levels. How to cite this article: Prabhakar H. Twenty-one Days of Solitude. Indian J Crit Care Med 2021;25(3):249-250.
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Affiliation(s)
- Hemanshu Prabhakar
- Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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42
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Moussa G, Samia-Aly E, Andreatta W, Lett KS, Mitra A, Sharma A, Tyagi AK, Ch'ng SW. The impact of COVID-19 on primary retinopexy in preventing retinal detachment in a tertiary eye hospital emergency department. Eur J Ophthalmol 2021; 32:534-538. [PMID: 33573420 DOI: 10.1177/1120672121994727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To review the effect of COVID-19 on rhegmatogenous retinal detachment (RRD) rate following primary retinopexy. METHODS Retrospective consecutive case series of 183 patients attending Birmingham and Midlands Eye Centre undergoing primary retinopexy (cryotherapy and laser) between March 23rd to June 30th in 2019 (Group 1) and 2020 (Group 2). RESULTS In total we reviewed 183 retinopexies, 122 in Group 1 and 61 in Group 2, a reduction of 50%. In Group 2 compared to Group 1, we showed a significant difference in characteristics of patients having primary retinopexy with an increase in proportion of male patients from 50 (41.0%) to 39 (63.9%) (p = 0.005), increase in high myopes from 1 (0.8%) to 4 (6.6%) (p = 0.043), more slit lamp laser retinopexy from 83 (68.0%) to 52 (85.2%) (p = 0.013) and less cryopexy from 21 (17.2%) to 2 (3.3%) (p = 0.008). In Group 2, primary retinopexy resulted in significantly more 3-month RRD rate 1 (0.8%) to 5 (8.2%) (p = 0.016). There were no changes in number of patients requiring further retinopexy (p = 1.000). CONCLUSION This study demonstrates a reduction of primary retinopexy, an increased risk for RRD following primary retinopexy and a significant shift in type of primary retinopexy performed, demographics, operator and change in characteristics of type of retinal break observed during this pandemic. This study contributes to the growing literature of the secondary effects of the COVID-19 pandemic on other aspects of healthcare that is not just limited to the virus itself.
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Affiliation(s)
- George Moussa
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Emma Samia-Aly
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Walter Andreatta
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.,Kantonsspital Winterthur, Winterthur, Switzerland
| | - Kim Son Lett
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Arijit Mitra
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Ash Sharma
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Ajai K Tyagi
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Soon Wai Ch'ng
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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