How glaucoma care changed for the better after the pandemic

Abstract

Purpose of review The current article reviews enhancements to the delivery of glaucoma care that developed in response to the coronavirus disease 19 (COVID-19) pandemic and are likely to persist beyond its resolution. Recent findings Literature from the review period (2020–2021) includes reports highlighting contributions of the ophthalmology community to global health during the pandemic. Glaucoma practices worldwide have instituted more robust infection control measures to mitigate severe acute respiratory syndrome coronavirus 2 transmission in the outpatient setting, and many of these modifications will endure in the post-COVID era. Operational adjustments have led to the provision of more efficient glaucoma care. A hybrid care model involving technician-based diagnostic testing and subsequent virtual consultation with a glaucoma specialist has evolved as a useful adjunct to traditional face-to-face encounters with patients. Summary Glaucoma specialists, patients, and staff have adapted to a ‘new normal’ of glaucoma care delivery during the COVID-19 pandemic. Although innovation has propelled several improvements to glaucoma care during this global health crisis, significant barriers to more widespread implementation of teleglaucoma still exist. Whether, and in what capacity, the pandemic has permanently altered glaucoma practice patterns remains to be seen.

Three-year Outcomes of an Expanded Asynchronous Virtual Glaucoma Clinic in Singapore

“…In contrast, the rapid turnover of patients in the GLOC model helped avoid stagnation and facilitate social distancing measures, allowing glaucoma patients to have continued access to care, thus reducing the risk of adverse outcomes due to poor follow-up. This model also catered to patients who were uncomfortable with physical consultations during this time 6,11 . We found the expanded model to have a high rate of safety, low rate of glaucoma progression, and to be time-efficient and cost-saving.…”

“…This model also catered to patients who were uncomfortable with physical consultations during this time. 6,11 We found the expanded model to have a high rate of safety, low rate of glaucoma progression, and to be time-efficient and cost-saving.…”

“…5 The recent coronavirus disease 2019 (COVID-19) pandemic has been a powerful catalyst for the implementation and scaling up of telemedicine initiatives. 6 At the Singapore National Eye Centre (SNEC), the Glaucoma Observation Clinic (GLOC), an asynchronous virtual clinic, was set up in 2018 as a followup scheme for stable glaucoma patients and to monitor those at increased risk of developing glaucoma. In a pilot study involving 377 patients from July 2018 to June 2019, we showed that GLOC reduced waiting and consultation times and manpower costs and was a sustainable model of care for managing patients with low risk of development or progression of glaucoma.…”

“…The Royal College of Ophthalmologists in the United Kingdom has issued guidelines to conduct virtual glaucoma clinics (VGCs) while increasing capacity 5 . The recent coronavirus disease 2019 (COVID-19) pandemic has been a powerful catalyst for the implementation and scaling up of telemedicine initiatives 6 . At the Singapore National Eye Centre (SNEC), the Glaucoma Observation Clinic (GLOC), an asynchronous virtual clinic, was set up in 2018 as a follow-up scheme for stable glaucoma patients and to monitor those at increased risk of developing glaucoma.…”

Recent developments of telemedicine in glaucoma

“…The field of ophthalmology and its subspecialty of glaucoma have observed an increased influence of telemedicine, particularly since the COVID-19 pandemic [1 ▪ ,2,3,4 ▪ –7 ▪ ]. Just in the last 3 years, there have been 137 studies published under the search criteria of “telemedicine” AND “glaucoma” in PubMed, in comparison with 146 total in the 21 years between 1998 and 2019.…”