Ophthalmology in the time of corona: Measures taken in a tertiary eye care hospital in Rajasthan against COVID-19 spread.

Abstract

Due to the COVID-19 outbreak in India, it becomes imperative to take preventive measures at the institutional level. Following national guidelines,[12] stringent measures were taken at Global Hospital Institute of Ophthalmology, Abu Road, the only tertiary eye care center in the southern region of Rajasthan which also caters to a large tribal population to prevent the hospital from being a focus of infection. Initially, an educational seminar was conducted to spread awareness amongst the hospital staff. At the entrance, a screening desk was setup to conduct triage and reschedule an appointment for nonemergency cases. A questionnaire was prepared to fill up in case the patient needed eye examination. Patients were permitted only after thermal screening and supervised hand sanitization. They were asked to wear a clothed mask being manufactured by the hospital foreseeing the unavailability of disposable surgical masks [Fig. 1].Figure 1: (a) Thermal screening. (b) Questionnaire administered to patients at the entrance. (c) Queue in front of the pharmacy maintaining social distance. (d) Display of advisory for prevention of COVID-19 spreadOphthalmologists paid special attention to features of viral conjunctivitis with systemic flu-like symptoms since knowledge about other ocular manifestations of COVID-19 infection is highly limited as of now.[3] [Fig. 2] Time-consuming procedures such as dilated refraction, dilated fundoscopy, and visual field analysis were deferred to reduce exposure to and from hospital staff. No elective surgeries were conducted and the cataract screening camps were postponed.Figure 2: (a and b) Patient being examined by optometrists and ophthalmologist, respectively while an attendant is kept seated at an adequate distance. (c) Slit-lamp examination being performed having breath shield installed, face masks, and gloves onTo ensure social distancing, the seating arrangement in the OPD was modified and queue with circular markings at an appropriate distance was painted outside the pharmacy. Mopping of the hospital floor and furniture was performed thrice daily with a 1% sodium hypochlorite solution.[4] The duty days of the hospital staff were also proportionally reduced to decrease exposure. Biometric fingerprint attendance was halted and staff attendance was registered manually.[12] Pamphlets containing information about COVID-19 were distributed in the community for awareness. The sarpanch of neighboring villages were asked to report suspicious cases at earliest. As of today, it remains to be seen how effective such measures of lockdown are, not only in the hospital but in all public places have been vis-à-vis other countries. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.