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. 2020 Sep 1;138(9):981-988.
doi: 10.1001/jamaophthalmol.2020.3237.

Practice Patterns and Responsiveness to Simulated Common Ocular Complaints Among US Ophthalmology Centers During the COVID-19 Pandemic

Matthew R Starr  1 , Rachel Israilevich  2 , Michael Zhitnitsky  3 , Qianqian E Cheng  1 , Rebecca R Soares  1 , Luv G Patel  1 , Michael J Ammar  1 , M Ali Khan  1 , Yoshihiro Yonekawa  1 , Allen C Ho  1 , Michael N Cohen  1 , Jayanth Sridhar  4 , Ajay E Kuriyan  1
Affiliations

Practice Patterns and Responsiveness to Simulated Common Ocular Complaints Among US Ophthalmology Centers During the COVID-19 Pandemic

Matthew R Starr et al. JAMA Ophthalmol. .

Abstract

Importance: The coronavirus disease 2019 (COVID-19) pandemic has drastically changed how comprehensive ophthalmology practices care for patients.

Objective: To report practice patterns for common ocular complaints during the initial stage of the COVID-19 pandemic among comprehensive ophthalmology practices in the US.

Design, setting, and participants: In this cross-sectional study, 40 private practices and 20 university centers were randomly selected from 4 regions across the US. Data were collected on April 29 and 30, 2020.

Interventions: Investigators placed telephone calls to each ophthalmology practice office. Responses to 3 clinical scenarios-refraction request, cataract evaluation, and symptoms of a posterior vitreous detachment-were compared regionally and between private and university centers.

Main outcomes and measures: The primary measure was time to next appointment for each of the 3 scenarios. Secondary measures included use of telemedicine and advertisement of COVID-19 precautions.

Results: Of the 40 private practices, 2 (5%) were closed, 24 (60%) were only seeing urgent patients, and 14 (35%) remained open to all patients. Of the 20 university centers, 2 (10%) were closed, 17 (85%) were only seeing urgent patients, and 1 (5%) remained open to all patients. There were no differences for any telemedicine metric. University centers were more likely than private practices to mention preparations to limit the spread of COVID-19 (17 of 20 [85%] vs 14 of 40 [35%]; mean difference, 0.41; 95% CI, 0.26-0.65; P < .001). Private practices had a faster next available appointment for cataract evaluations than university centers, with a mean (SD) time to visit of 22.1 (27.0) days vs 75.5 (46.1) days (mean difference, 53.4; 95% CI, 23.1-83.7; P < .001). Private practices were also more likely than university centers to be available to see patients with flashes and floaters (30 of 40 [75%] vs 8 of 20 [40%]; mean difference, 0.42; 95% CI, 0.22-0.79; P = .01).

Conclusions and relevance: In this cross-sectional study of investigator telephone calls to ophthalmology practice offices, there were uniform recommendations for the 3 routine ophthalmic complaints. Private practices had shorter times to next available appointment for cataract extraction and were more likely to evaluate posterior vitreous detachment symptoms. As there has not been a study examining these practice patterns before the COVID-19 pandemic, the relevance of these findings on public health is yet to be determined.

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Conflict of interest statement

Conflict of Interest Disclosures: Drs Khan and Cohen have received personal fees for consulting from Allergan. Dr Yonekawa has received personal fees from Alcon, Allergan, and Genentech. Dr Ho has received grants from Genentech as well as financial support from Allergan, Alcon, and Iconic Therapeutics. Dr Sridhar has received personal fees for consulting from Alcon and Regeneron. Dr Kuriyan has received grants from Roche/Genentech and Second Sight and personal fees for consulting from Roche/Genentech, Allergan, Alimera Sciences, Bausch Health, Regeneron, and Novartis. No other disclosures were reported.

Figures

Figure.
Figure.. Heat Map of the US With Prevalence of Coronavirus Disease 2019 (COVID-19) Infections as of April 30, 2020
The map overlays displays of time to refraction request, cataract evaluation, and posterior vitreous detachment examination for each practice within this study. Larger dots represent higher prevalence of COVID-19 infection and longer times to evaluation for each clinical scenario.
See this image and copyright information in PMC

Comment in

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