Virtual Visits in Ophthalmology: Timely Advice for Implementation During the COVID-19 Public Health Crisis

Bowe, Theodore; Hunter, David G.; Mantagos, Iason S.; Kazlas, Melanie; Jastrzembski, Benjamin; Gaier, Eric D.; Massey, Gordon; Franz, Kristin; Schumann, Caitlin; Brown, Christina; Meyers, Heather; Shah, Ankoor S.

doi:10.1089/tmj.2020.0121

Cited by 22 publications

(17 citation statements)

References 4 publications

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“…30,31 Further, there is growing evidence that different parts of the world are affected differently due to both socioeconomic factors and genetic factors. 32 This means that different parts of the world will (29) Foreign body (22) Hordeolum/chalazion (18) Keratitis (21) Retinal detachment (70) Visual disturbances (25) Retinal detachment (20) Retinal detachment (10) Hordeolum/chalazion (20) respond differently to the pandemic and that patterns identified in this study may not apply to all countries around the world.…”

Section: Discussionmentioning

confidence: 96%

“…At the same time, in the wake of the COVID-19 pandemic, many ophthalmology clinics have changed their practice to reduce the risk of exposure by adopting telemedicine for many routine visits, while trying to develop more home-based testing or hybrid approaches. [22][23][24][25] Clinical Frequency and Prevalence Ratios of Diagnostic Groups. List of top 5 primary diagnostic groups that presented to the MEE ED between March 1st and April 30th in 2018, 2019, and 2020 with the corresponding number of presentations in parentheses.…”

Section: Discussionmentioning

confidence: 99%

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<p>The Impact of the COVID-19 Pandemic on Ophthalmic Care at an Eye-Specific Emergency Department in an Outbreak Hotspot</p>

Moon¹,

Miller²,

Katz³

et al. 2020

OPTH

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During the COVID-19 pandemic, there is growing concern that patients are forgoing necessary care. Emergency departments (ED) represent an important site of eye care. We analyzed patterns of ED visits at an eye-specific ED since the declaration of the public health crisis. Materials and Methods: In this retrospective, cross-sectional single center study, medical records of 6744 patients who presented to the Massachusetts Eye and Ear ED between March 1st and April 30th in 2018, 2019, and 2020 were studied. The primary outcome measures were total volume of ED visits, proportion of urgent ED visits, and proportion of surgical visits. Results: Overall, the median number of daily visits to the ED decreased by 18 visits per day since the declaration of public health guidelines (interquartile range, 9-24, p < 0.001). This accounted for a 32% decrease in the total volume of ED visits in 2020 compared to prior years during the study period (p < 0.001). There was a 9% increase in the proportion of primary diagnoses considered urgent (p = 0.002). The proportion of visits requiring urgent surgery increased by 39% (p = 0.004). Conclusion: The total number of eye-specific ED visits dropped compared to prior years while the proportion of urgent visits increased. Patients were likely more reluctant to seek eye care, deferring less urgent evaluation.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

<p>The Impact of the COVID-19 Pandemic on Ophthalmic Care at an Eye-Specific Emergency Department in an Outbreak Hotspot</p>

Moon¹,

Miller²,

Katz³

et al. 2020

OPTH

View full text Add to dashboard Cite

show abstract

“…Adherence to these recommendations has resulted in an estimated 75% or more reduction of in-person clinic volumes [28]. Concurrently, the implementation of telemedicine visits resulted in an alternative way to provide continued care [3,25,[29][30][31]. However, the exact reduction of in-patient visits, increase in telemedicine encounters, and the change in the types of diagnoses seen within in an ophthalmology clinic before and after COVID-19 remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Changes in patient visits and diagnoses in a large academic center during the COVID-19 pandemic

Berkenstock¹,

Liberman

McDonnell³

et al. 2021

BMC Ophthalmol

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Background To minimize the risk of viral transmission, ophthalmology practices limited face-to-face encounters to only patients with urgent and emergent ophthalmic conditions in the weeks after the start of the COVID-19 epidemic in the United States. The impact of this is unknown. Methods We did a retrospective analysis of the change in the frequency of ICD-10 code use and patient volumes in the 6 weeks before and after the changes in clinical practice associated with COVID-19. Results The total number of encounters decreased four-fold after the implementation of clinic changes associated with COVID-19. The low vision, pediatric ophthalmology, general ophthalmology, and cornea divisions had the largest total decrease of in-person visits. Conversely, the number of telemedicine visits increased sixty-fold. The number of diagnostic codes associated with ocular malignancies, most ocular inflammatory disorders, and retinal conditions requiring intravitreal injections increased. ICD-10 codes associated with ocular screening exams for systemic disorders decreased during the weeks post COVID-19. Conclusion Ophthalmology practices need to be prepared to experience changes in practice patterns, implementation of telemedicine, and decreased patient volumes during a pandemic. Knowing the changes specific to each subspecialty clinic is vital to redistribute available resources correctly.

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“…Despite reports of conjunctivitis and red eyes as symptoms of COVID-19, all types of conjunctivitis continued to have a statistically signi cant decrease in the 6 weeks following COVID-19, except viral conjunctivitis, which decreased in frequency but not signi cantly. [24][25][26][27][28][29][30][31][32] The largest statistically signi cant decreases were seen in post-cataract follow-up visits, as evidenced by a decrease in ICD-10 codes for posterior capsular opaci cation and pseudophakia.…”

Section: Discussionmentioning

confidence: 99%

Changes in Patient Visits and Diagnoses seen in an Academic Ophthalmology Department during the COVID-19 pandemic

Berkenstock¹,

Liberman²,

McDonnell³

et al. 2020

Preprint

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BACKGROUND: To minimize the risk of viral transmission, ophthalmology practices limited face to face encounters to only patients with urgent and emergent ophthalmic conditions, in the weeks after the start of the COVID-19 epidemic in the United States. The impact of this is unknown. METHODS: We did a retrospective analysis of the change in the frequency of ICD-10 code use and patient volumes in the six weeks before and after the changes in clinical practice associated with COVID-19.RESULTS: The total number of encounters decreased four-fold after the implementation of clinic changes associated with COVID-19. The low vision, pediatric ophthalmology, general ophthalmology, and cornea divisions had the largest total decrease of in-person visits. Conversely, the number of telemedicine visits increased sixty-fold. The number of diagnostic codes associated with ocular malignancies, most ocular inflammatory disorders, and retinal conditions requiring intravitreal injections increased. ICD-10 codes associated with ocular screening exams for systemic disorders decreased during the weeks post COVID-19. CONCLUSION: Ophthalmology practices need to be prepared to experience changes in practice patterns, implementation of telemedicine, and decreased patient volumes during a pandemic. Knowing the changes specific to each subspecialty clinic is vital to redistribute available resources correctly.

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Virtual Visits in Ophthalmology: Timely Advice for Implementation During the COVID-19 Public Health Crisis

Cited by 22 publications

References 4 publications

<p>The Impact of the COVID-19 Pandemic on Ophthalmic Care at an Eye-Specific Emergency Department in an Outbreak Hotspot</p>

<p>The Impact of the COVID-19 Pandemic on Ophthalmic Care at an Eye-Specific Emergency Department in an Outbreak Hotspot</p>

Changes in patient visits and diagnoses in a large academic center during the COVID-19 pandemic

Changes in Patient Visits and Diagnoses seen in an Academic Ophthalmology Department during the COVID-19 pandemic

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