Are Ophthalmology Practices Following COVID Guidance for Patient Visits?
JAMA Ophthalmology, September 2020
On March 18, 2020, the Academy recommended that all ophthalmologists provide only urgent and emergency care, as determined by their judgment. Starr et al. assessed whether comprehensive ophthalmology practices in the United States followed this guidance and found that most providers had complied. Before scheduling urgent visits, all practices were likely to ask patients about COVID-19 symptoms.
For this study, the investigators placed scripted phone calls on April 29 and 30 to private practices (n = 40) and university centers (n = 20) that were chosen randomly. The calls represented patient requests for three clinical scenarios: refraction, cataract evaluation, and symptoms of posterior vitreous detachment (PVD). Responses to the requests were compared regionally and between private practices and university centers. The main outcome measure was time to next appointment for each scenario. Secondary measures included use of telemedicine and emphasis of COVID-19 precautions.
Of the 40 private practices, two (5%) were closed, 24 (60%) were seeing only patients with urgent needs, and 14 (35%) were open to all patients. Of the 20 university centers, two (10%) were closed, 17 (85%) were open just for urgent care, and one (5%) was open for all patients. University centers were more likely than private practices to require precautions to limit spread of the virus (85% vs. 35%). The next available appointment for cataract assessment was earlier for private practices (mean, 22.1 vs. 75.5 days). Private entities also were more likely than university centers to continue seeing patients with flashes and floaters (75% vs. 40%), which can signal PVD. The only regional difference was that practices in the South scheduled cataract consults earlier than did practices elsewhere. The responses of centers in areas of higher COVID prevalence were similar to those in areas of lower prevalence. Less than 20% of practices were offering telemedicine.
The original article can be found here.