Abstract
Purpose :
The COVID-19 pandemic caused disruptions in ophthalmic care, and may have negatively impacted some patients more than others. We performed a retrospective, cross-sectional study at our large, tertiary care ophthalmology referral center in the Midwest region of the United States in an attempt to identify patients at risk for worsening ocular health during the COVID-19 shutdowns.
Methods :
We completed retrospective Electronic Health Record data extraction of demographic and clinical outpatient encounter-level data for all patients examined in our department from March-May 2019, August-October 2019, March-May 2020 (peak COVID), and August-October 2020 (COVID recovery). Changes in mean logMAR visual acuity (logMAR VA), mean intraocular pressure (IOP), and mean number of procedures per encounter were tested and stratified by age (<18, 18-64, and 65+ years-old), and compared based on associated billing codes.
Results :
During peak COVID, there was a 73% decrease in the number of outpatient clinical encounters compared to the control time period in 2019 (6,976 vs. 26,068), and mean patient age was significantly lower during peak COVID (mean age 53.4, 95% CI 52.8-54.0) compared with the other time periods. Documented best-corrected logMAR VA of the right and left eyes worsened for pediatric, adult, and elderly patient age groups; IOP of the right and left eyes worsened when evaluating all patients together; and the mean number of procedures performed per encounter increased by 74% comparing early 2019 to peak COVID months. The billing diagnoses associated with the worst ocular health outcomes during the COVID-related shutdowns include patients with anophthalmia of the fellow eye; infectious keratitis; open, chronic angle closure, and secondary causes of glaucoma; ocular inflammatory disorders; optic neuritis and ischemic optic neuropathies; and vitreoretinal disorders related to diabetes, macular degeneration, and vitreous or retinal hemorrhages.
Conclusions :
Patients seen during the COVID-19 pandemic were younger, had worsened logMAR VA, increased IOP, and underwent more procedures compared to the COVID-recovery and 2019 control months. Numerous billing diagnoses were associated with worse measures ocular health. Patients with these ocular disorders may need prioritization during future periods of reduced access ophthalmic care.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.