Effects of Covid-19 on walk-in and after hours ophthalmology presentations at a tertiary academic eye center

Abstract

Purpose: The novel coronavirus 2019 (Covid-19) has resulted in millions of acute infections and widespread lockdowns. Non-emergent medical care and elective surgical procedures experienced a sharp downturn as a result. The primary aim of this study was to determine the effect of the pandemic lockdown on the volume of ophthalmologic visits at a tertiary care center. Methods: Retrospective review of 3647 patient encounters was conducted for periods February 15thJuly 31st during the years 2018, 2019, and 2020. Three sub-cohorts of data were analyzed: emergency room consultations, after-hours on-call visits, and daytime visits at a walk-in triage clinic. Encounters were subdivided into pre-lockdown, lockdown, and post-lockdown time periods. Group comparisons were performed with Poisson probability testing. Results: A total of 1322, 1349, and 976 ophthalmology visits were recorded from February 15th to July 31st for years 2018, 2019, and 2020, respectively. Total visits in 2020 were reduced by 27% when compared to the mean visits for 2018 and 2019, most notably in April (41%), March (34%), May (32%), and June (86%) [p<0.001]. The reduction in 2020 after-hours visits (96%, p<0.001) was significantly greater than that of emergency room consultations (9.4%, p=0.10) and triage center visits (7.7%, p<0.02). Conclusion: A substantial decrease in ophthalmic care was observed during both the 2020 pandemic lockdown, and while restrictions were eased. After-hours visits were more significantly impacted when compared to other clinical settings. The importance of maintaining ophthalmology walk-in clinics, telemedicine, and increasing patient education are key to optimizing eye health during a global pandemic.