Patient Care Guidelines of Ophthalmic Injuries During COVID-19: A Systematic Review

Abstract

Background: Coronavirus disease 2019 pandemic and lockdown have changed human behaviors and physician practice patterns. Trauma centers reported decreased numbers of injuries during the lockdown. Ophthalmic injuries are urgent conditions and may introduce risks to the health personnel during patient care. Objective: To study the epidemiological trends and to review the guidelines of patient care regarding ophthalmic injuries during the present study period. Materials and Methods: A systematic search was performed in PubMed, Scopus, Cochrane library, and all Web of Science databases. Duplicated and non-relevant articles were excluded. Thirty-eight articles were independently reviewed by all authors, conflicts resolved by consensus. Guidelines retrieved from ophthalmic associations were summarized. Results: The pooled incidence of eye injury was 17.8% (95% CI 10.2% to 29.2%). Eight articles were included in the meta-analysis for changes in numbers of ophthalmic injury cases, which showed no statistically significant change of percentage of cases during the lockdown comparing with the pre-lockdown, Odds Ratio 1.653 (95% CI 0.826 to 3.309), p=0.155). Causes of trauma were mainly from gardening and home improvement projects. Corneal and external eye injury were the main diagnoses. Guidelines of ophthalmic injury patient care stated about the risk stratification, coronavirus disease screening, and the preventive measures to limit virus spread during the caregiving. Conclusion: There was no significant reduction of the incidence of ophthalmic injury during the Coronavirus disease 2019 pandemic and lockdown period. The causes of injury were mainly from the stay-at-home activities. Therefore, the authors suggest that eye protection when doing home maintenance should be advocated to the public for preventive measures even when they are less exposed to the outside environment. When the injuries occur, the primary care at the emergency department should include risk stratification, screening, and prevention of virus spreading as the key roles in the ophthalmic injury patient care. Keywords: Ocular trauma, Ophthalmic injury, Epidemiology, COVID-19, Coronavirus