The Impact of the First Peak of the COVID-19 Pandemic on a Paediatric Ophthalmology Service in the United Kingdom: Experience from Alder Hey Children’s Hospital

Abstract

Objective: The COVID-19 pandemic has led to significant service loss across the NHS, and ophthalmology is one of the greatest affected specialties. We attempt to quantify the impact of the first peak of the COVID-19 pandemic on a paediatric ophthalmology unit in a children's hospital in the United Kingdom (UK) and report lessons learnt to aid in the recovery of the service. Methods and Analysis:Two eight-week periods of clinical activity were compared; one during the first UK peak of the COVID-19 pandemic and the other during a similar period the previous year. Four areas of clinical activity were included in the study: outpatient clinic appointments, theatre activity, outpatient referrals to ophthalmology and ward reviews. Appointment data was collected from departmental databases.Results: During the first peak of the pandemic, outpatient clinic appointments were reduced by 87.2%, ophthalmic surgery by 90.9%, outpatient referrals to ophthalmology by 50.2% and ward reviews by 50%. The number of actual cancelled appointments was 1377, of which 6.8% were triaged as suitable for teleophthalmology. Conclusion:The COVID-19 pandemic has dramatically restricted clinical activity in the ophthalmology service. Paediatric ophthalmology is vulnerable to capacity issues and the consequences of delayed or cancelled appointments. Departments must adapt quickly and maximise capacity to help reduce the backlog and treat patients effectively and safely. Solutions such as teleophthalmology have potential although can be difficult in the paediatric population.

Impact of COVID 19 pandemic lockdown in pediatric ophthalmology service in Kedia eye hospital, Nepal

“…This study of four months period reported that there was decline in the children attending the hospital by 84%. Similar reduction was seen in the study by Kausher et al [2,4] . In urban areas of Birgunj, with the start of lockdown all the school, playground, parks were closed and gathering of children were stopped.…”

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).…”

The impact of COVID-19 pandemic on ophthalmic referrals within a tertiary academic center in Oman

“…[ 5 ] A similar impact was observed on outpatient referrals to a pediatric ophthalmology service in UK which was reduced by 50.2%. [ 6 ] In this study, the most reduction was from the outpatient department (by 66.6%), which is expected due to reduced patient volumes booked in outpatient clinics. However, numerous studies confirmed the largest fall to be from the ED, which in our study was 50.6% reduction in ED referrals alone.…”

“…In addition, most of our population from the young pediatric age group, we assume, will be difficult to assess remotely and still require a face-to-face assessment. [ 6 ]…”