Impact of the pandemic on clinical management of glaucoma

Objective

To conduct a systematic review looking into the effects of the COVID-19 pandemic on the clinical management of glaucoma.

Methods/analysis

Literature was thoroughly searched through MEDLINE, CINAHL, Google Scholar, EMBASE, and ClinicalTrials.gov until August 5, 2020. Two levels of screening were performed independently by two authors. Kappa Statistics were used to test interrater reliability at each level of screening. The included articles were assessed for risk of bias using a checklist by CLARITY group. Data were extracted from the included articles and qualitative analysis was conducted.

Results

A total of 224 records were screened based on the Title/Abstract screening leaving 17 records. These 17 records went through Full-Text screening leaving 9 records for qualitative analysis. The articles outlined the barriers, recommended guidelines, and implemented guidelines used in glaucoma management during the COVID-19 pandemic. Five key pieces of information were extracted from the studies. First, the barriers to glaucoma management during the COVID-19 pandemic were extracted from all the articles. Second, pre-diagnosis and outpatient management protocols were extracted from seven of the articles. Third, specific hygiene and protective protocols that were followed during diagnosis and treatment, such as for clinical examinations, gonioscopy, tonometries, and personal protective equipment used were extracted from five of the articles. Fourth, telemedicine approaches to the management of glaucoma were extracted from four of the articles. Fifth, comprehensive information on the disinfection and sanitization protocol used in the clinical management of glaucoma was extracted from five articles.

Conclusion

Multiple healthcare organizations are taking sound steps in changing the clinical management of glaucoma during the COVID-19 pandemic. More studies on pre-diagnosis, outpatient management, specific hygiene, and disinfection and sanitization protocol will be helpful to ensure safer use of the equipment and effective glaucoma management in these challenging times.