An upheaval like we are in the midst of hasn’t been seen since World War II. SARS-CoV-2 is an enveloped, single-stranded RNA virus that causes COVID-19 – The coronavirus or Coronavirus Disease. It will have lasting effects long after herd immunity and a vaccine are developed. Interestingly, the first person to truly sound the alarm of what was to come with COVID-19 was an eye doctor from Wuhan, China. His name was Li Wenliang. After seeing a SARS (Severe Acute Respiratory Syndrome)-like illness in patients, he attempted to warn his colleagues and the world of the pending deadly infectious outbreak. Ultimately, he contracted COVID-19 and died shortly after at the age of 33. He was not the only one, as there were 2 more eye doctors in Wuhan, China that died from COVID-19.
COVID-19 will affect eye care in several ways.
COVID-19 and the Eye
First, COVID-19 may affect the eye itself and present as a viral conjunctivitis in 1-3% of patients. It is a relatively rare symptom and unlikely to be present without fever and cough. It is a mild follicular conjunctivitis very similar to other viral causes that give you the classic “pink eye.” This could be due to transmission via direct contact of conjunctiva and aerosolized virus. We are early in studying the new or “novel” coronavirus pandemic and only have a rough idea of how it spreads and presents in patients. We know it spreads fast. It went worldwide within 4 months grounding countries to a halt with lockdowns around the world. Symptoms and severity are quite variable in each patient with older patients (>65 years of age) with underlying health conditions at greatest risk.
Protecting patients will be our top priority during in-office care and new guidelines and procedures have been developed and implemented with likely many more changes to come. There will be careful screening of patients prior to their exam to ensure no fever, cough or contact with COVID-19 positive patients. Family members or other companions will need to be limited for office visits. All paperwork and questionnaires will need to be completed before the office visit to avoid the multi-person use of pens, clipboards, papers, etc. Patients may check-in from their cars and be asked to wait there until notified via cell phone their appointment is ready to begin. Staffing will be minimized in accordance with social distancing recommendations. The transmissibility of COVID-19 through the air from seemingly asymptomatic patients seems to be a defining feature of enhanced viral spread and so masks will a common feature of the exam- both for patients and the doctors. While we regret this intrusion into our doctor-patient interaction, it will likely be necessary for the foreseeable future. There will be new, more stringent disinfection protocols in place. Selecting new glasses will be a new experience as well. New disinfection policies and limitations will be in place to ensure every pair of glasses is safe to try on.
Delivery of Care
We have been thrust into the world of telehealth. To be sure, it was coming, but our circumstances and the public health declaration made the future now. There will be face-to-face examinations over FaceTime, Skype and other available applications that allow evaluation of the eyes and address patients’ complaints. A major portion of eye disease can be diagnosed and treated with digital communication, provided the doctor can view a patient’s eye and obtain an accurate history. Technology will continue to create new opportunities to effectively handle refractive and eye conditions via telehealth. At this time, we have good capability to diagnose and treat a red eye, eye injury and any number of vision related issues via telehealth. In the near future, we will be able to provide care for glaucoma, macular degeneration and refractive conditions like nearsightedness via telehealth. We have made our online services for glasses and contact lenses available to save trips to our office.
Eye care and its delivery has changed and will continue to evolve in these turbulent times. We hope all our patients are taking proper precautions and you and your love ones remain safe and healthy. We are always here for any eye care needs – just a call, email, text, video or click away.