Virtual ophthalmology care may assume permanent role after pandemic
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LAS VEGAS — Virtual assessments filled gaps in ophthalmology patient care during the COVID-19 pandemic and may reduce unnecessary in-person visits, according to a presentation here.
At the American Society of Cataract and Refractive Surgery meeting, Jenny Ma, MD, said COVID-19 presented a difficult challenge for the delivery of ophthalmology care.
“Over 3 months of the COVID-19 lockdown period, most optometry and ophthalmology clinics were closed,” she said. “Virtual eye assessments emerged to fill a gap in patient care.”
Researchers conducted a retrospective, cross-sectional study of all virtual assessments from March 24, 2020, to June 7, 2020, at Prism Eye Institute, Toronto, to determine if virtual care models achieved the goal of reducing in-person visits during the pandemic. They also wanted to find out if the virtual assessments were able to catch vision-threatening conditions and provide safe patient care.
Overall, 1,535 virtual assessments were included, 1,300 over the phone and 235 over email. The most common nonurgent presentations were ocular surface disease/dry eye disease (23%), posterior vitreous detachment/flashes and floaters (16%) and conjunctivitis (5%). Semi-urgent or urgent presentations included iritis (10%) and neovascular glaucoma or uncontrolled IOP (4%).
There were 17 unplanned additional visits to the emergency department. Among this group, three patients required surgery, two had their diagnosis changed, two had their treatment changed, and eight were advised to continue their present management; the outcome was not specified in two cases.
In a quality assurance survey, 38% of patients said they would have sought care at an emergency department if the virtual portal did not exist, and 41% would have gone to another physician. Additionally, 63% of patients said they were either satisfied or very satisfied with the virtual assessment.
“While most cases were not urgent, we found that caution must be exercised to not miss vision-threating conditions, particularly those of retinal nature,” Ma said. “As providers become more acquainted with virtual care during the pandemic, we may observe it assuming a more permanent role in clinic workflows in the future.”
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Ma J, et al. Urgent virtual eye assessments during the COVID-19 pandemic. Presented at: American Society of Cataract and Refractive Surgery meeting; July 23-27, 2021; Las Vegas.
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