{"title":"Effect of COVID-19 Shelter-In-Place Orders on Visual Outcomes of Ophthalmic Surgical Emergencies.","authors":"Rebecca I Chen, Elizabeth A Vanner, Ta Chen Chang","doi":"10.1080/09286586.2024.2384067","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare the outcomes of ophthalmic surgical emergencies during shelter-in-place (SIP) order with the corresponding period in 2019.</p><p><strong>Methods: </strong>This retrospective cohort study compared patients presenting to the Bascom Palmer Eye Institute (BPEI) emergency department (ED) who underwent urgent surgery during the SIP period (March 23-May 17, 2020), compared to the same weeks in 2019 (non-SIP). Main outcome measures included symptom-to-ED time, ED-to-surgical decision time, surgical decision-to-operating room (OR) time, ED-to-OR time, and postoperative follow-up time. Secondary outcome measures included travel distance, visual acuity (VA), intraocular pressure (IOP), and number of glaucoma medications.</p><p><strong>Results: </strong>Seventy-six and 148 patients presented with ophthalmic surgical emergencies in the SIP and non-SIP study periods, respectively. Retinal detachment (RD), acute glaucoma, and open globe injury were the most common diagnoses in both periods. Symptom-to-ED and surgical decision-to-OR times were shorter during the SIP period. SIP patients had comparable preoperative VA but worse postoperative VA compared to non-SIP patients. During the SIP period, RD patients experienced postoperative VA reduction rather than improvement (+0.09 vs. -0.23 logMAR, <i>p</i> = 0.03); glaucoma patients were less likely to reach surgical decision within 24 h (OR 0.16 [95% CI 0.03-0.95]); and globe injuries had longer ED-to-surgical decision time and ED-to-OR time compared to the non-SIP period. Other outcomes were similar between both study periods.</p><p><strong>Conclusion: </strong>There was reduced volume of ophthalmic surgical emergencies and worse postoperative vision during SIP compared to the non-SIP period, despite shorter symptom-to-ED and surgical decision-to-OR times suggesting minimal delays in seeking or receiving care.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":1.7000,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmic epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/09286586.2024.2384067","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To compare the outcomes of ophthalmic surgical emergencies during shelter-in-place (SIP) order with the corresponding period in 2019.
Methods: This retrospective cohort study compared patients presenting to the Bascom Palmer Eye Institute (BPEI) emergency department (ED) who underwent urgent surgery during the SIP period (March 23-May 17, 2020), compared to the same weeks in 2019 (non-SIP). Main outcome measures included symptom-to-ED time, ED-to-surgical decision time, surgical decision-to-operating room (OR) time, ED-to-OR time, and postoperative follow-up time. Secondary outcome measures included travel distance, visual acuity (VA), intraocular pressure (IOP), and number of glaucoma medications.
Results: Seventy-six and 148 patients presented with ophthalmic surgical emergencies in the SIP and non-SIP study periods, respectively. Retinal detachment (RD), acute glaucoma, and open globe injury were the most common diagnoses in both periods. Symptom-to-ED and surgical decision-to-OR times were shorter during the SIP period. SIP patients had comparable preoperative VA but worse postoperative VA compared to non-SIP patients. During the SIP period, RD patients experienced postoperative VA reduction rather than improvement (+0.09 vs. -0.23 logMAR, p = 0.03); glaucoma patients were less likely to reach surgical decision within 24 h (OR 0.16 [95% CI 0.03-0.95]); and globe injuries had longer ED-to-surgical decision time and ED-to-OR time compared to the non-SIP period. Other outcomes were similar between both study periods.
Conclusion: There was reduced volume of ophthalmic surgical emergencies and worse postoperative vision during SIP compared to the non-SIP period, despite shorter symptom-to-ED and surgical decision-to-OR times suggesting minimal delays in seeking or receiving care.
期刊介绍：
Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.
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