UK ophthalmologists will try to maintain service for patients at high risk for visual loss without treatment

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Michael Burdon MD FRCS
In a EuroTimes interview, RCOphth President, Michael Burdon MD FRCS, provides his insights into COVID-19’s impact on ophthalmology in the UK. "UK ophthalmologists around the country are preparing themselves for the full impact of the COVID-19 pandemic in line with the preparation being put in action by the NHS in general. And in parallel with NHS guidelines, the RCOphth’s recommendations are based on the principle that patient safety is our priority and we face the challenge of achieving a balance between patients risk of significant visual loss without treatment and the increased risk of coronavirus infection from leaving home and attending hospitals and clinics. Since most ophthalmic surgery patients are over 70 years of age and have significantly co-morbidity, what we are really saying, effectively, is that patients should be staying at home unless there is a really good reason. Therefore as of today we will be recommending that all routine ophthalmic surgery and routine visits should be postponed whether in HNHS hospitals or private clinics. But we will try to maintain a service for patients who are at high risk for visual loss without treatment. For example, we will try as much as is practically possible to continue providing macular degeneration patients with anti-VEGF treatments and also maintain as much as possible ophthalmic services for retinal detachments endophthalmitis, rapidly progressive glaucoma and ocular oncology. We will be looking to maintain a ophthalmology at the emergency department which will be ultimately consultant triaged and led, but that is dependent on the resources available and how safe it is for patients. Currently because ophthalmologists will stop doing routine surgeries and check-ups we are in a temporary position where we have an excess capacity. Our policy there is that if you don’t need to be in the department you shouldn’t be there. But in a few weeks’ time it is likely that we will have ophthalmologists deployed to cover our colleagues elsewhere in hospital and some of us will come down with the virus and at that point it may be that the resources of the NHS are unable to maintain the critical ophthalmology services that we would like . Overall there will possibly be a cohort of patients with chronic diseases, glaucoma patients, for example, who will effectively have missed out on one of their twice-a-year appointments which might have led to a treatment change that would in the long term affect their vision. But provided we have been able to identify high risk patients and try our best to continue to see them actually none of that may happen . The impact will also be seen in the significant backlog of patients and that will be generic across all aspects of the health service across the world at the moment. We will enter the phase where coronavirus will dominate everything we do and after that in a few months’ time when the pandemic subsides we can begin to plan the future. What we want to do now is protect our patients both from the virus and from severe visual loss, and it is challenging but we’re up for it." *In conversation with Roibeard O’hEineachain .
Tags: covid-19