The Effect of Lockdown due to COVID-19 on a Large Emergency Eye Department: The Manchester Experience

Aim: This study assesses the impact of the UK COVID-19 lockdown on Ophthalmology Emergency Services at one of the largest dedicated Emergency Eye Departments in the UK. Methods: We evaluated differences in attendances between 2019 and 2020 according to ethnicity, deprivation scores, age, clinician grade, diagnosis, discharge rate and follow up length. Results: The mean number of attendances started to drop on the 17th March 2020. The mean number of attendances before versus after 17th March decreased by a factor of 2.2 with a 95% (CR) of (2.1,2.3); from 72 (95%CR 70,75) per day to 33 (95%CR 31,35). Attendance rates to the Emergency Eye Department during a 9-week period of lockdown dropped by 51% (95%CI 47-52%) compared with the same period in 2019 and 48% (95% CI50-54%) compared with 2018. There was no significant difference in patient age, ethnicity or index of deprivation quintile between 2019 and 2020. There was a 61% drop (95% CI 48-70%) in the number of eye emergencies presenting in the second week of lockdown (30/04/2020–05/04/2020) compared to the corresponding period in 2019. Community eye emergencies dropped by 74% (95%CI 64-80%) and non-eye emergencies dropped by 64% (95%CI 47-75%). Conclusion: Government measures to reduce the transmission of COVID-19 have had a significant impact on the attendance of patients to our Emergency Eye Department. Severe blinding conditions are not presenting as frequently. This raises the concern that once the restrictions of COVID-19 are fully lifted some patients might start to present with potentially incurable chronic ocular conditions with devastating secondary complications.