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    Thoughts From Your Colleagues

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    Indirect Effects of the Pandemic

    Physicians are only beginning to understand the lasting effects of the pandemic on patients. Many, even those who have not been infected with COVID-19, have delayed treat­ments and checkups for various reasons over the past year.

    I recently treated a 54-year-old woman who was referred to our clinic for “blurry vision.” She described six months of persistent and profound vision loss. Her vision was 20/40 and light perception in her right and left eye, respectively. On exam, there was extensive neovascularization of the disc and retina, multiple preretinal hemorrhages, and profound peripheral vascular nonperfusion in the right eye and a macula-involving traction retinal detachment in the left eye.

    The day before we saw her, the patient sought care for her visual symptoms at the emergency department (ED), where she was diagnosed with uncontrolled diabetes and hypertension. Her last eye exam was five years prior, and she was followed by her OB-GYN for primary care. She was em­ployed, well-insured, and worked at a medical facility—but as I discussed the findings with her, it became apparent that her fear, anxiety, and status as the sole caregiver and driver for her whole family during the height of the COVID-19 pandemic delayed her presentation to the ED.

    As we move toward a new normal, we will continue to care for patients who have—directly and indirectly—been affected by the pandemic in ways we could have never anticipated.

    Patricia C. Nelson, MD, FACS
    Texas Tech University Health Sciences Center
    El Paso, Texas