Optimization of Glaucoma Management During a Pandemic: Drive-Through IOP Checks

Abstract

Purpose : In this pilot study, we compared the efficacy of drive-through intraocular pressure (IOP) checks in combination with E-health visits to E-health visits alone in the management of glaucoma patients during the COVID-19 pandemic.

Methods : We performed a retrospective chart review for visits from April 2020 – November 2020 to compare subjects that received E-health visits (Group 1) versus subjects that received E-health visits with a drive-through IOP check (Group 2). Drive-through visits consisted of temperature screening with a non-contact infrared thermometer, near visual acuity check, and IOP measurements using a Tono-Pen XL Tonometer (Reichert, Depew, NY) followed by a video E-health visit with a glaucoma specialist. Group 1 patients only attended a video visit. We compared the proportion of interventions done at the visit as well as changes in visual acuity (VA) and IOP after the tele-visits between the 2 groups. The 4 types of interventions were: change in drop type, change in drop frequency, change in number of drops, and recommending surgical or laser intervention.

Results : 28 subjects were included in our pilot study (mean age 74.9 +/- 3.8 years, 57.1% female). There was no significant difference in baseline characteristics between group 1 (n=15) and group 2 (n=13, Table 1). 6.7% of Group 1 patients had an intervention done compared to 38.5% of group 2 patients. Fisher exact probability testing showed a significant increase in the proportion of interventions done in group 2 subjects compared to group 1 subjects (p=.041), with the most common interventions being changing number of drops and drop frequency. There was no significant difference in changes in VA or IOP between the 2 groups (Table 1).

Conclusions : Drive-through IOP checks in combination with virtual visits resulted in more interventions than virtual visits alone in the care of glaucoma patients during the COVID-19 pandemic. This novel healthcare modality can address the mismatch between capacity and demand for glaucoma care both during a pandemic and can further expand access to sub-specialized care.

This is a 2021 ARVO Annual Meeting abstract.

 

Table 1: Comparison of baseline patient demographics, visit characteristics, and intervention types between E-health alone and drive through with E-health groups. 95% confidence intervals and proportions shown in parentheses. Single-factor ANOVA compared mean values and Fisher exact probability testing compared proportions between the 2 groups.