Access to eye care during the COVID-19 pandemic, India

Muralikrishnan, Janani; Christy, Josephine S; Srinivasan, Kavitha; Subburaman, Ganesh-Babu B; Shukla, Aakriti Garg; Venkatesh, Rengaraj; Ravilla, Thulasiraj

doi:10.2471/blt.21.286368

Cited by 12 publications

(10 citation statements)

References 13 publications

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“…reported that the number of out-patient visits at tertiary care centers reduced to 39%, whereas that of vision centers reduced to 73% of the prepandemic 2019 levels during the first wave. [ 9 ] The same trend was observed by them during the second wave of the COVID-19 pandemic. This highlights the fact that the vision centers are easy to access as they are closer to the local communities and additionally have the advantage of offering specialized care via telemedicine.…”

Section: Discussionsupporting

confidence: 69%

“…The various barriers during the lockdown included lack of public transportation, loss of income, financial constraints, reduced caregiver access if they are staying at different homes, and inability to seek tertiary healthcare among various others. [ 9 - 11 ] The Government of India made it mandatory to get a travel pass facilitating emergency travel during the lockdown periods. Glaucoma is asymptomatic in a majority and even among those with symptoms, rarely does it present acutely.…”

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confidence: 99%

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Changes in emergency glaucoma care during the COVID-19 pandemic in South India

Krishna

Odayappan

Venkatesh

et al. 2023

Indian Journal of Ophthalmology

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Purpose: To assess the differences in the pattern of presentation of glaucoma emergency conditions during the various phases of pandemic-related travel restrictions: first wave-related lockdown, unlock period, and the second wave-related lockdown. Methods: The number of new emergency glaucoma conditions, the various diagnoses, and the total number of all new glaucoma patients presenting to the glaucoma services at five tertiary eye care centers in south India from 24 th March 2020 to 30 th June 2021 were collected from the electronic medical records and were analyzed. The data were compared with the corresponding time period in the year 2019. Results: In total, 620 patients presented with an emergency glaucoma diagnosis during the first wave-related lockdown as against 1337 during the same period in 2019 ( P < 0.0001). During the unlock period, 2659 such patients visited the hospital compared with 2122 in 2019 ( P = 0.0145). During the second wave-related lockdown, there were 351 emergency patients compared with 526 patients in 2019 ( P < 0.0001). Lens-induced glaucomas (50.4%) and neovascular glaucoma (20.6%) were the most common diagnoses during the first wave-related lockdown. During the unlock period, there was a greater proportion of neovascular glaucoma ( P = 0.0123). The second wave-related lockdown had a greater proportion of phacolytic glaucomas ( P = 0.005) and acute primary angle closure ( P = 0.0397) patients. Conclusion: The study demonstrates that emergency glaucoma care was grossly underutilized by the people during the lockdowns. Trivial conditions like cataracts or retinal vascular diseases if not treated appropriately may progress to become emergencies in the future.

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Section: Discussionsupporting

confidence: 69%

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confidence: 99%

Changes in emergency glaucoma care during the COVID-19 pandemic in South India

Krishna

Odayappan

Venkatesh

et al. 2023

Indian Journal of Ophthalmology

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“…But considering the current barriers to access AMD treatment and rehabilitation services in many regions, even a minor increase in absolute numbers might put pressure on the already overloaded public health systems. The reduced availability of ophthalmic services during the Covid-19 pandemic 14 and the economic impact that might be seen during the post-pandemic years can increase barriers in the management of chronic eye conditions, like AMD.…”

Section: Discussionmentioning

confidence: 99%

Global estimates on the number of people blind or visually impaired by age-related macular degeneration: A meta-analysis from 2000 to 2020

Furtado

Bourne

2023

Preprint

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Background:We aimed to update estimates of global vision loss due to age-related macular degeneration (AMD). Methods:We did a systematic review and meta-analysis of population-based surveys of eye diseases from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60) caused by AMD, stratified by age, region, and year. Results:In 2020, 1.85 million (95%UI: 1.35-2.43 million) people were blind due to AMD, and another 6.23 million (95%UI: 5.04-7.58) million presented with MSVI globally. High-income countries hadthe highest number of individuals with AMD-related blindness (0.60 million people; 0.46-0.77). The crude prevalence of blindness due to AMD in 2020 (among those aged ≥ 50years) was 0.10% (0.07-0.12) globally, and the region with the highest prevalence of blindness due to AMD was North Africa/Middle East (0.22%; 0.16-0.30). Age-standardized prevalence of MSVI due to AMD in people aged ≥ 50 years in 2020 was 0.34% (0.27-0.41) globally, and the region with the highest prevalence of MSVI due to AMD was also North Africa/Middle East (0.55%; 0.44-0.68). From 2000 to 2020, the crude prevalence of blindness due to AMD decreased globally by 19.29% (19.57 to 19.01%), while the prevalence of MSVI increased by 10.08%(9.81 to 10.34%). Conclusions:The increase in the number of individuals with AMD-related blindness and MSVI globally due to population growth and ageing urge for creation of novel treatment modalities and the expansion of rehabilitation services.

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“…There was a 72.82% drop in the patients presenting from outside the state due to the travel restrictions that were in force in different parts of India. Muralikrishnan et al described a decrease in the patients with glaucoma during the pandemic period (0.8% vs 1%) as compared to the prepandemic period but saw an increase in the lens induced glaucoma (0.03% vs <0.01%) during the pandemic period (18). Ayub et al described a 92.52% decrease in their outpatient clinical visits among glaucoma patients in the first year of the pandemic (March 2020-February 2021) (19).…”

Section: Discussionmentioning

confidence: 99%

Year One of COVID-19 Pandemic: Effect on Presentation of Patients With Glaucoma in a Multi-Tier Ophthalmology Network in India

Das

Senthil²

2022

Front. Ophthalmol.

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ObjectiveTo describe the demographics and clinical profile of patients with glaucoma presenting during the novel coronavirus (COVID-19) lockdown and unlock phases in India.MethodsThis retrospective hospital-based comparative study included patients presenting between March 25, 2017, and March 31, 2021. All patients who presented with glaucoma disorders were included as cases. The demographic and clinical data of these glaucoma patients were collected using an electronic medical record system.ResultsOverall, 34,419 patients (mean 47 per day) diagnosed with glaucoma diseases presented to the network and were included for analysis. The mean age of the patients was 54.16 ± 18.74 years and most were male (n=21,140; 61.42%) from the urban region (n=12,871;37.4%). On categorizing based on the timeline of the COVID-19 pandemic, most of the patients presented pre-COVID-19 (n=29,122; 84.61%), followed by a minority (n=175; 0.51%) during the lockdown and the rest (n=5,122; 14.88%) during unlock phase. An increasing number of patients with secondary glaucoma (n=82; 46.86%) and presenting from the local intra-city (n=82; 46.86%) was seen during the lockdown. There was a 6.6-fold increase in neovascular glaucoma and a 2.7-fold increase in lens induced glaucoma during the lockdown phase ((p<0.001) for both). There was a significant increase in subjects in 4th decade (p<0.03) and a decrease in subjects in 7th decade (p<0.008) during the lockdown period.ConclusionThe presentation of patients with glaucoma disorders to the hospital is evolving due to the COVID-19 pandemic. The footfalls of patients during the unlock regained to two-thirds of the pre COVID-19 level. During the lockdown, the older patients were less, there was an increase in younger patients and those with secondary glaucoma, and the majority presenting from within the city.

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Access to eye care during the COVID-19 pandemic, India

Cited by 12 publications

References 13 publications

Changes in emergency glaucoma care during the COVID-19 pandemic in South India

Changes in emergency glaucoma care during the COVID-19 pandemic in South India

Global estimates on the number of people blind or visually impaired by age-related macular degeneration: A meta-analysis from 2000 to 2020

Year One of COVID-19 Pandemic: Effect on Presentation of Patients With Glaucoma in a Multi-Tier Ophthalmology Network in India

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