Abstract
Purpose :
During the COVID-19 lockdown, many patients delayed seeking medical care. The purpose of this study is to evaluate the trends of emergent ophthalmic care during and after the COVID-19 lockdown at an academic safety-net health system with a level 1 trauma center.
Methods :
A retrospective chart review of 3610 encounters seen at the University of Virginia Emergency Department with a primary ophthalmic diagnosis was completed from March 2018 to December 2022. Number of encounters, patient demographics, and visit acuity were compared across years using an analysis of variance test. Homogeneity was assessed with Levene’s test, Q-Q variation, and a Welch analysis when necessary.
Results :
During the pandemic year there was a decrease in number of patients, males, females, Caucasians, African Americans, English speakers, patients who are self-pay, age 20-65, living within one hour of the hospital, and moderate acuity visits compared to the two years prior (p<0.001). Hispanics (p=0.003), Spanish speakers (p=0.003), patients insured privately (p=0.001) or by Medicaid (p=0.002), age 0-6 (p=0.005) or living within 60 to 90 minutes from the hospital (p=0.005) also decreased during the pandemic year. There was not a significant drop in other races, other languages, patients insured by Medicaid, age 6-20, age 65 and older, living greater than 90 minutes from the hospital, or mild and severe acuity in the pandemic year. Compared to pre-pandemic visits, there was a significant increase in 2022 of females, patients who are non-caucasian, african american or hispanic, patients insured by Medicaid, Medicare, self-pay, age 65 and older or within 30 minutes of the hospital. Moderate acuity visits decreased while moderate-severe and severe visits increased in 2022 compared to pre-pandemic visits (p<0.001).
Conclusions :
The number of eye-related emergency encounters decreased significantly during the pandemic year and then recovered by 2021. Notable exceptions included small minority groups, age over 65, and those living over 90 minutes away. Moderate acuity visits decreased during the pandemic year and continued to remain low for years afterward while more severe acuity continued to increase. This increased severity may suggest that delays in presentation during the pandemic may have led to more advanced disease states as a consequence of the pandemic.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.