Changes in patient visits and diagnoses in a large academic center during the COVID-19 pandemic

Abstract

Background: To minimize the risk of viral transmission, ophthalmology practices limited face-to-face encounters to only patients with urgent and emergent ophthalmic conditions in the weeks after the start of the COVID-19 epidemic in the United States. The impact of this is unknown.

Methods: We did a retrospective analysis of the change in the frequency of ICD-10 code use and patient volumes in the 6 weeks before and after the changes in clinical practice associated with COVID-19.

Results: The total number of encounters decreased four-fold after the implementation of clinic changes associated with COVID-19. The low vision, pediatric ophthalmology, general ophthalmology, and cornea divisions had the largest total decrease of in-person visits. Conversely, the number of telemedicine visits increased sixty-fold. The number of diagnostic codes associated with ocular malignancies, most ocular inflammatory disorders, and retinal conditions requiring intravitreal injections increased. ICD-10 codes associated with ocular screening exams for systemic disorders decreased during the weeks post COVID-19.

Conclusion: Ophthalmology practices need to be prepared to experience changes in practice patterns, implementation of telemedicine, and decreased patient volumes during a pandemic. Knowing the changes specific to each subspecialty clinic is vital to redistribute available resources correctly.

Keywords: COVID-19; Epiphenomena; Ocular diagnoses; Ophthalmology; Telemedicine.

Fig. 1

Diagnostic Categories by Subspecialty

Fig. 2

A bar graph depicting the change in the percentage of in-person visits by subspecialty in each study period. Significant differences are marked with an asterisk (*)

Fig. 3

External photograph of pseudodendrites as seen in a patient with herpetic keratitis