Ophthalmic emergency-room visits during the Covid-19 pandemic – a comparative study

Abstract

Background The goal of this study is to compare ophthalmic emergency room (OER) visits during the Coronavirus disease-19 (Covid-19) pandemic to those during a control period. Methods We compared all visits to the OER to Meir Medical Center in Israel, from March 15th to April 15th, 2020, during the Covid-19 pandemic and government mandated quarantine, to the same period in 2019. Factors analyzed were patient demographics, chief complaints, referral patterns, exam findings, treatments given, hospitalizations and surgical interventions. Results We included in this study 1311 visits of 1158 patients, 477 during the 2020 Covid-19 pandemic and 834 during the same period in 2019. The demographic distribution (age, gender, and ethnicity) was similar between the two periods. LogMAR visual acuity at presentation was worse during the Covid-19 pandemic (0.42 ± 0.6 and 0.34 ± 0.5 in 2020 and 2019 respectively; p = 0.025) and the number of emergent surgeries was higher (3.7% in 2020 vs 1.8% in 2019, p = 0.026). In 2019 there was a higher likelihood of involvement of both segments of the eye (4.82% versus 1.2%, p < 0.01) and more diagnoses were given to each patient (1 ± 0.5 versus 0.93 ± 0.35, p = 0.001; During the Covid − 19 pandemic medications (both topical and systemic) were prescribed more often (1.22 ± 0.95 in 2020 and 0.84 ± 0.67 in 2019, p < 0.001). Conclusions OER visits were less frequent during the Covid − 19 pandemic as compared to 2019, though the demographics of the patients remained unchanged. Visits during the pandemic tended to be for more severe ocular conditions, with worse visual acuity at presentation and required more medical and surgical treatment which imply higher necessity of ocular evaluation. This analysis can aid healthcare resource management in similar scenarios in the future.

Changing trends in ophthalmological emergencies during the COVID-19 pandemic

“…Our data showed that conjunctivitis was the most common diagnosis in the ophthalmological emergency department before the pandemic; this finding is consistent with other studies [11,12]. As other authors have remarked [8,10,13], conjunctival pathology consultations decreased significantly during the COVID-19 pandemic. In April 2020, conjunctival pathology represented 17.9% of ophthalmology consultations in our hospital, compared with 28% in April 2019.…”

Impact of the COVID-19 pandemic and Honey Rose case on hospital attendances of patients suspected to have papilloedema

“…Reports from USA demonstrated that ophthalmology was the specialty with the largest decrease in outpatient visits, reducing by 79-81% in April/May 2020 (27,28). Similar decreases in ophthalmology attendances were reported as far a eld as UK, Spain, Israel, Italy, Canada and New Zealand (29)(30)(31)(32)(33)(34)(35), although the greatest concern was that sight-threatening cases were presenting later and with worse visual acuities than previous years or simply not presenting to a clinician at all; suggesting fear of vision loss was less than fear of attending hospital during the rst peak of the pandemic (23,30).…”

COVID-19 Changed Prevalence, Disease Spectrum and Management Strategies of Ocular Trauma

“…Several studies have reported an overall decreasing trend in the morbidity of ocular trauma, and the number of emergency eye services has also decreased during the COVID-19 era, especially for traffic and work-related trauma. Meanwhile, interpersonal violence-related injuries were at a relatively high level ( 21 – 27 ). A case-control study in the United Kingdom noted that within the first month after the national lockdown order was issued, the total number of ophthalmological emergency visits decreased by 53.1% compared with the same period the year before.…”