Ophthalmology Visit Patterns during the COVID-19 Pandemic: An AAO IRIS Registry Analysis

Abstract

Purpose : The COVID-19 pandemic significantly impacted standard ophthalmology visit patterns in the United States. This study uses the AAO IRIS (Intelligent Research in Sight) Registry to examine ophthalmology visit patterns preceding and throughout COVID across patient, provider, and practice characteristics. Understanding the changes in care as a result of a pandemic could aid in planning for future crises.

Methods : Demographic, practice, and provider data were extracted for one million patients selected at random from the IRIS Registry. For purposes of analysis, three time periods were identified: Pre-COVID, January 1^st, 2019 to March 13^th, 2020, when the United States declared COVID-19 a national epidemic; Peak-COVID, March 13^th to June 1^st, 2020, when practices halted non-urgent visits; and Reduced Operations, the remainder of 2020 when practices resumed non-urgent appointments. Regression analysis was used to estimate the effect of COVID-19 on patient visit probabilities across several patient demographics as well as the relationship between practice characteristics and their changes in visit rates throughout COVID.

Results : From March 13^th to June 1^st, 2020, overall visit rates decreased by 52% compared to pre-COVID rates. As practices resumed non-urgent visits, visit stabilized at 85% of their pre-COVID rates through the remainder of the year (p<0.001).
The effect of COVID on visit rates was most pronounced on older patients (p<0.001). Among providers, subspecialties that tend to see more emergency visits were the least affected by COVID. Vitreoretinal specialists experienced the smallest proportional decline in visits through peak COVID and the reduced operations period, decreasing by only 34% and 13% respectively compared to pre-COVID rates (p<0.001). Oculoplastic and refractive surgeons observed the largest proportional reduction in visits during both COVID periods. Larger practices experienced a greater negative effect on visit rates compared to smaller practices (p<0.001). Practices in the Northeast were disproportionally effected by the pandemic (p<0.001), particularly during peak-COVID, when the Northeast was the initial epicenter of the disease.

Conclusions : COVID-19 most significantly impacted ophthalmology visit rates among older patients, oculoplastic and refractive subspecialties, larger practices, and practices in the Northeast.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.