Impact of COVID-19 pandemic on eye-related ED visits

The COVID-19 pandemic has had a significant impact on the number of eye-related ED visits and there is a need better health education

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Ceren Durmaz Engin MD
The COVID-19 pandemic has had a significant impact on the number of eye-related ED visits and there is a need better health education, according to Ceren Durmaz Engin MD, Dokuz Eylul University, Izmir,Turkey. In a Free Paper presented at the 25th ESCRS Winter Meeting Virtual 2021, Dr Durmaz Engin said the highest decrease was seen in the frequency of acute conjunctivitis cases which may be secondary to hand hygiene and social distancing measures. "Delayed health-seeking behaviour for subtle or less debilitating symptoms due to fear of contracting the virus by hospital attendance may cause the decrease of ED visits for not likely emergent conditions," said Dr Durmaz Engin."Taking lessons from the COVID period, more rational use of emergency services can be achieved by health education." In her study, Dr Durmaz Engin and her research team compared the characteristics of eye-related emergency department (ED) visits with ophthalmology consultation during the COVID-19 pandemic in 2020 against an equivalent period in 2019 Records of 838 patients who admitted to ED for ophthalmic complaints between 11th of March 2020 (date of first COVID-positive case in the country) to 11th of September 2020 (Period 1 - P1) and 1585 patients who admitted to ED at equivalent period in the previous year (Period 2 - P2) were examined. The urgency status of complaint, diagnosis, treatment applied, hospitalization status of patients and total cost of health expences by institution were compared. Records of first 3-months (11th March-3th June) and second 3-months (3th June to 11th September) in 2020 were also compared to reveal the effect of lockdown. The study found that there was a 47.1% reduction in ED admissions between Period 1 and Period 2. The lockdown also caused a 29% reduction in ED visits for ocular complaints. The top diagnostic categories were corneal abrasion (CA) (percentage of total caseload: 21.3%), corneal foreign body (CFB) (16.6%) and acute conjunctivitis (12.7%) during P2 and CFB (29.5%), CA (13%) and orbital floor fracture (7.4%) during P1. While 64.5% of the total cases were likely emergent in P2, the frequency increased to 79.4% during P1 (p<0.001). The type of treatment (p=0.089) and hospitalization status (p=0.29) were not different between two study periods. There was a 44.3% reduction in health expenses. The study concluded that the COVID-19 pandemic had had a significant impact on the number of eye related ED visits. The highest decrease was seen in the frequency of acute conjunctivitis cases which, said Dr Durmaz Engin, may be secondary to hand hygiene and social distancing measures. "Delayed health seeking behaviour for subtle or less debilitating symptoms due to fear of contracting the virus by hospital attendance may cause the decrease of ED visits for not likely emergent conditions. Taking lessons from the COVID period, more rational use of emergency services can be achieved by health education," she said.
Tags: covid 19 eye related emergency department admissions, ESCRS Winter Virtual 2021, Ocular