Patients wait longer, travel farther for emergency ophthalmic care during pandemic
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A study found patients requiring emergency ophthalmic care during COVID-19 stay-at-home orders were less likely to have health insurance, more likely to delay seeking treatment and traveled farther for care, according to a presentation.
“There were several significant differences in characteristics of ocular trauma cases presented to the Wills Eye emergency room during the COVID-19 stay-at-home orders,” Connie Wu, MD, said in a poster presentation at the virtual American Academy of Ophthalmology annual meeting.
The comparative cohort study investigated patients who visited the emergency department at Wills Eye Hospital, Philadelphia, from March 18 through April 15, 2019, and from March 23 through April 20, 2020. Patients with severe ocular trauma including eyelid and ocular lacerations, ruptured globe, chemical conjunctivitis, hyphema, foreign body, vitreous or choroidal hemorrhage, commotio retinae and retinal tears and detachments were included in the study.
Overall, fewer patients sought care during the COVID-19 study period than in the similar period in 2019: 62 cases vs. 87 cases. In 2019, 97% of patients had health insurance compared with 79% in 2020.
“We found a significantly fewer proportion of patients who presented to the emergency room with health insurance. Whether this represents the rise in unemployment during the pandemic remains to be confirmed, though it was an interesting finding that may highlight a barrier to emergency care during a health care crisis,” Wu said.
Patients also traveled farther and waited longer from time of injury to presentation in 2020, Wu said. Patients traveled a mean of 29.98 miles to the emergency department in 2020, an increase of 19.6 miles over the similar period in 2019. Patients also waited a mean of 36 hours in the 2020 period vs. 14 hours in 2019 to seek care.
In the 2020 period, 84% of injuries occurred at home, whereas 20% occurred at home in the 2019 period. Most injuries were caused during amateur home improvement projects while the injured was not wearing appropriate eye protection, Wu said.
“This study underscores the need for targeted patient education, such as emphasis of proper home eye protection and when to seek urgent ophthalmic care,” Wu said.
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Wu C, et al. Ocular trauma during COVID-19 stay-at-home orders: A comparative cohort study. Presented at: American Academy of Ophthalmology annual meeting; Nov. 13-15, 2020 (virtual meeting).
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