Abstract
Background:To characterise and compare ocular pathologies presenting to an emergency eye department (EED) during the COVID-19 pandemic in 2020 against an equivalent period in 2019.Methods:Electronic patient records of 852 patients in 2020 and 1818 patients in 2019, attending the EED at a tertiary eye centre (University Hospitals of Leicester, UK) were analysed. Data was extracted over a 31-day period during: (study period 1 (SP1)) COVID-19 pandemic lockdown in UK (24th March 2020–23rd April 2020) and (study period 2 (SP2)) the equivalent 2019 period (24th March 2019–23rd April 2019).Results:A 53% reduction in EED attendance was noted during lockdown. The top three pathologies accounting for >30% of the caseload were trauma-related, keratitis and uveitis in SP1 in comparison to conjunctivitis, trauma-related and blepharitis in SP2. The overall number of retinal tears and retinal detachments (RD) were lower in SP1, the proportion of macula-off RD’s (84.6%) was significantly (p = 0.0099) higher in SP1 (vs 42.9% in SP2).Conclusion:COVID-19 pandemic related lockdown has had a significant impact on the range of presenting conditions to the EED. Measures to stop spread of COVID-19 such as awareness of hand hygiene practices, social distancing measures and school closures could have an indirect role in reducing spread of infective conjunctivitis. The higher proportion of macula-off RD and lower number of retinal tears raises possibility of delayed presentation in these cases. Going forward, we anticipate additional pressures on EED and other subspecialty services due to complications and associated morbidity from delayed presentations.
Highlights
COVID-19 is caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and was declared a pandemic by the World Health Organisation (WHO) on 11th March 2020.1 As of 2nd August 2020, more than 17 million cases of COVID-19 with over 680,000 deaths have been reported worldwide.[2]
The first case of COVID-19 was reported in the United Kingdom (UK) on 30th January 2020, and the first mortality on 5th March 2020.3 In response to this pandemic, the UK government issued national lockdown orders on the 23rd March 2020, with an aim to contain the rates of infection and reduce anticipated pressures on the National Health Service (NHS)
In this study we highlight the changing trends in ocular pathologies presenting to an eye emergency department during COVID-19 pandemic related lockdown
Summary
COVID-19 is caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and was declared a pandemic by the World Health Organisation (WHO) on 11th March 2020.1 As of 2nd August 2020, more than 17 million cases of COVID-19 with over 680,000 deaths have been reported worldwide.[2] in the United Kingdom (UK), over 300,000 COVID-19 confirmed cases and in excess of 46,000 related deaths have been reported.[2] The first case of COVID-19 was reported in the UK on 30th January 2020, and the first mortality on 5th March 2020.3 In response to this pandemic, the UK government issued national lockdown orders on the 23rd March 2020, with an aim to contain the rates of infection and reduce anticipated pressures on the National Health Service (NHS) Additional restrictions such as strict home isolation was advised for ‘clinically vulnerable’ (e.g. those aged 70 years or older) and ‘clinically extremely vulnerable’ individuals (e.g. patients on immunosuppression therapies).[4] The Royal College of Ophthalmologists (RCOphth), UK, have provided guidance on ophthalmic service delivery during the COVID-19 pandemic. Going forward, we anticipate additional pressures on EED and other subspecialty services due to complications and associated morbidity from delayed presentations
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