Impact of COVID-19 outbreak on eye care: A cross-sectional single center descriptive study in North India.

Dear Editor, Due to the COVID-19 pandemic, many health services, including eye care, have been affected. Delayed ophthalmic services have led to a direct and indirect effect on eye care and resulted in various complications like vision loss, blurred vision, etc., Although many public and private hospitals introduced telemedicine to provide consultation for nonemergency complaints, very few studies are available on the impact of the COVID-19 pandemic on eye care and the utility of telemedicine services on access to care through telemedicine. Hence, a study was undertaken with the objective to determine the clinical presentation, treatment pattern, outcomes, and challenges faced by patients to access eye care among patients visiting the triage area of eye OPD at a tertiary-care institute. A descriptive study was conducted on 200 participants having ophthalmic problems visiting ophthalmic OPD [Mar 2–Mar 13, 2021] at a tertiary-care institute by using the total enumeration sampling technique. The study was approved by the Institutional Ethics Committee. Data was collected by interviewing patients after taking informed written consent as per the interview schedule comprised of three subparts – 1) sociodemographic data of patient, 2) clinical profile of patient, and 3) interview performa for patients having ophthalmic problems. The results were coded and analyzed by using SPSS Software 25. Results Out of 200 participants, 82% had acute eye symptoms, 18% had chronic eye diseases, i.e. glaucoma, cataract, diabetic retinopathy, etc., which required follow-up. The common ophthalmic symptoms reported were blurred vision (42%), itching (18.2%), pain (15.8%), redness of eyes (13.8%), dry eyes (3.6%), eyelids swelling (3%), burning sensation (3%), and watery eyes (0.6%). Eye specialists in the private center were consulted by 38% participants, 10% visited government center, few patients (2%) consulted general practitioners, and 1.5% of patients took home remedies (e.g., honey), Ayurvedic medicine, or over-the-counter medicines to manage eye problems during COVID-19. Patients faced problems like increased lens number due to delayed eye treatment (7%), and could not get the medicine in time (6%). Treatment delay was reported by 93 (46.5%) participants due to late appointment, planned surgeries were postponed (4.5%), and follow ups were missed. Due to it, they faced symptoms worsening (excessive eye discharge, blurred vision, pain, redness of eyes, itching, decrease eyesight, etc.) and 28% reported having undergone a financial crisis due to heavy consultation fees in the private sector. More than half, i.e., 112 (56%) of participants used telemedicine services for ophthalmic problems. Among them, 63 (56.2%) participants faced problems while using teleconsultation such as call not connected, call not picked up by anyone. Half of the participants (50.8%) needed to use teleconsultation two or more times because their call was not connected and received. At the same time, 43.8% of patients were satisfied with teleconsultation and video conferencing. Conclusions Treatment of eye care delayed and patients faced problems of symptoms worsening or underwent financial crisis due to heavy fees in the private sector. Although teleconsultation was the preferred mode for eye care services during the pandemic, many patients faced problems while using these services. There is a need to improve the quality of teleconsultation services as increasingly digital services become the new norm in health care delivery after the COVID-19 pandemic. Ethical approval The study was approved by the Institutional Ethics Committee. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.