Impact of COVID-19 Pandemic on Ophthalmic Presentations to an Australian Outer Metropolitan and Rural Emergency Department: A Retrospective Comparative Study

Abstract

Background To analyse ophthalmic presentations to an outer metropolitan and a rural emergency department (ED) during the COVID-19 pandemic in New South Wales (NSW), Australia. Methods A retrospective comparative study of ophthalmic emergency presentations to Campbelltown Hospital (fifth busiest NSW metropolitan ED; population 310,000) and Bowral and District Hospital (rural ED; population 48,000) before and during COVID-19 was conducted. Patient demographics, triage category, referral source, diagnosis, length of stay, departure status, and follow-up location were assessed from coding data between March 1st to May 31st in 2019 and 2020, corresponding to the peak case numbers and restrictions during COVID-19 in NSW. Differences before and during COVID-19 were analysed using chi-squared tests or independent sample t-tests. Results There was no change in ophthalmic presentations at Campbelltown (n = 228 in 2019 vs. n = 232 in 2020; +1.75%, p = 0.12) and an increase at Bowral (n = 100 in 2019 vs. n = 111 in 2020; +11%, p < 0.01) during COVID-19. Urgent ophthalmic presentations (Triage Category 3) decreased at Bowral (p = 0.0075), while non-urgent ophthalmic presentations (Triage Category 5) increased at both hospitals (Campbelltown p < 0.05, Bowral p < 0.01). Conclusions An upward and varied trend in ophthalmic presentations to an outer metropolitan and a rural ED was observed. Heterogeneous ophthalmic presentation trends at peripheral EDs suggest that a high demand for ophthalmic services remained. A flexible healthcare delivery strategy, such as tele-ophthalmology, may optimise patient care during and after COVID-19.