How COVID-19 affected pivots of Ophthalmology? The optics and the eyes

Abstract

The pandemic has forced the health-care system to adopt newer approach toward patient care. With the changing scenario of health-care delivery, ophthalmologists had to bring about several changes in the way, the patients are seen and operated on. Contact procedures were entirely restricted to emergencies while modifications were introduced to minimize the exposure of the surgeon. However, these modifications were introduced just keeping in mind the spread of infection. The probability that these modifications could affect the optics in ophthalmology is high and cannot be ruled out. The aim of the study was to highlight the effects of modifications introduced in ophthalmic equipment during the pandemic over the visibility for the surgeon and discuss its impact on patient care in ophthalmology. Thorough search of the literature on PubMed using keywords, visibility and personal protective equipment (PPE), fogging and PPE, face mask and fogging, aberrations and PPE, and surgeries and PPE were done. We found 35 articles which highlighted the effects on visibility with PPE and effects on eyes with prolonged wearing of masks. Several factors have contributed to reduction in visibility for the surgeon. These factors have, in turn, affected the overall quality of examination and surgical outcome in ophthalmology. The use of PPE during the pandemic could have been a contributory factor for missing relevant findings during examination of patients. For ophthalmologists in particular, the visibility and optics play a crucial role in the management of the patient and have been invariable affected by introduction of modifications at the instrument and surgeon level.