Journal of Eye Diseases and Disorders

Effects of the COVID 19 Pandemic on the Availability of Emergency Eye Treatment at Manchester Royal Eye Hospital

Jonas Ries^* Department of Ophthalmology, Peking University, Beijing, China
^*Correspondence: Jonas Ries, Department of Ophthalmology, Peking University, Beijing, China, Email:

Received: 02-Sep-2022, Manuscript No. JEDD-22-18535; Editor assigned: 06-Sep-2022, Pre QC No. JEDD-22-18535 (PQ); Reviewed: 20-Sep-2022, QC No. JEDD-22-18535; Revised: 27-Sep-2022, Manuscript No. JEDD-22-18535 (R); Published: 04-Oct-2022, DOI: 10.35248/2684-1622.22.7.182

About the Study

The pandemic of COVID-19 has posed global health care challenges. This paper examines the impact of the pandemic on patient numbers, demographics, type, and severity of Emergency Eye Department (EED) presentations at one of the largest tertiary referral eye hospitals in the United Kingdom (UK), as well as the management strategies developed.

Coronavirus Disease (COVID-19) has emerged as a global health threat, posing significant challenges to the provision of eye care. Because of the rapidly increasing number of new cases outside of China, the World Health Organization (WHO) declared this disease a pandemic on March 11, 2020. There were 9,473,214 cases and 4,84,249 deaths worldwide as of June 26th, 2020. The growing demand for specialized care has affects healthcare systems around the world. It has become clear that there is no single approach to addressing the challenges posed, and each unit must adapt based on the resources available locally.

The National Health Service (NHS) in the United Kingdom (UK) has had to undergo extensive changes in order to deal with the surge of patients presenting with COVID-19 symptoms. The return of over 10,000 healthcare professionals has greatly bolstered the NHS. Furthermore, 27,000 student nurses, medical students, and other health professionals began working for the NHS earlier than expected. In addition, 6,07,000 people signed up to be NHS volunteers. A significant amount of work was completed in collaboration with local government, social care, the voluntary sector, the military, hospices, and the private sector. The difficulties encountered were not limited to the care of COVID-19 patients. In order to provide a safe environment for the treatment of non-COVID-19 patients, self-isolation and social distancing measures were also developed. Following the implementation of tele-consultations, all routine outpatient activities were reduced to 25% capacity, with efficient triage playing a significant role. This reduced the risk of COVID-19 exposure to staff and patients while allowing for safe patient care. All surgical activities were suspended to allow for staff training and redeployment to meet the growing demand.

A shift in patient demographics, disease presentations, and patient preferences in ophthalmology has resulted in a steady increase in the demand for emergency eye care over the years. According to a 2017 publication from the Royal College of Ophthalmologists (RCOpth), the incidence of new eye casualty attendances was approximately 20-30 per 1000 UK citizens per year, with eye emergencies accounting for 1.46%-6% of all accident and emergency (A&E) attendances.

The Manchester Royal Eye Hospital (MREH) is one of the largest eye tertiary referral centres in the UK, with a 24-hour oncall service and an 8 a.m. to 8 p.m. walk-in Emergency Eye Department (EED). Because of the COVID-19 pandemic, we have had to change the processes for providing urgent eye care. Due to the COVID-19 pandemic, the EED was burdened by limited local optometrist services and face-to-face general practitioner consultations. A number of strategies have been developed to reduce the risk of transmission. These included staff training to screen for potential COVID-19 patients at triage, appropriate personal protective equipment, use of slit lamp breath shield, equipment disinfection, staff risk assessment, washable at high temperatures staff uniforms, and supervised entry to the hospital premises to control visitor numbers.

To separate any potential COVID-19 positive patient from others, a new patient flow pathway through the emergency eye department was devised. Telephone consultations were increased to ensure that patient advice and care could be delivered remotely and to reduce the number of unnecessary hospital visits. In a designated area, a pre-triage area was set up to screen for any patients with potential COVID-19. All patients were asked about COVID-19 symptoms such as fever, cough, shortness of breath, and contact with COVID-19 positive people. Any suspected COVID-19 patients were treated in an isolation room in this area. If the patient was not suspected of having COVID-19, they were given permission to enter the EED. Patients in the EED were triaged and then given an electronic pager to wait outside the clinical area before being seen. This process reduced the number of people in EED and promoted social distancing.

Patients requiring follow-up care who were deemed low risk were given telephone consultations known as welfare calls instead of being seen in the Primary Care Physicians (PCP's) acute followup clinics. Face-to-face appointments in subspecialty clinics were made for patients who were at higher risk. Following welfare calls, some patients needed to return to EED or a subspecialty clinic if they needed ongoing follow-up. COVID-19 swabs were taken from patients who were admitted or needed surgery. Telephone interpreters were encouraged to be used instead of face-to-face interpreters for patients who needed an interpreter. In addition to EED presentations, MREH had about 150 daily outpatient attendances. The model we used at the MREH allowed us to provide clinical care effectively while also allowing for flexibility when resources were limited. We intend to expand on this in the post-COVID-19 period to meet the growing demand for emergency eye care services.