Ophthalmologic emergency room visits during COVID-19 lockdown–Characterization from Haifa, Israel

Abstract

Purpose To characterize quantitative differences among ophthalmologic emergency room (OER) encounters at Rambam Health Care Campus during a 6-week complete lockdown at the peak of the first COVID-19 wave as compared to a corresponding uneventful period a year earlier. Methods A retrospective chart analysis of all OER encounters during the lockdown and non-lockdown period was conducted. Patients were stratified into primary ophthalmological conditions (OER visits) and cases in which ophthalmologic consultations were requested by a non-ophthalmologist (OER consultations). The following parameters were compared: total number of cases, age, gender, chief complaint/diagnosis categorized into major entities, and discharge vs. hospitalization. For continuous variables a t-test was used and for categorical variables a chi-squared or Fisher’s exact test was used. A 2-sided p value <0.05 was considered statistically significant. Results The total number of patients in the lockdown and non-lockdown groups was 486 and 992, respectively, showing a 51% decrease in visits during lockdown. In the non-lockdown and lockdown groups 56% and 61% of patients were male (p = 0.07), with an average age of 42 (range 0–97, SD 23) and 43 (range 0–90, SD 22) years, respectively (p = 0.44). No statistically significant proportional increase was found for any diagnostic category between the OER visits (p = 0.07) and OER consultation groups (p = 0.77). Nevertheless, analysis revealed a non-significant increase in the proportion of eye trauma from 14.8% to 21.2%, and reduction in eyelid conditions from 10.7% to 5.8%. The total number of OER visits demanding urgent intervention on admission was 43 (non-lockdown) and 24 (lockdown), while hospitalization ratio (hospitalizations/visits) was 8.8% and 10.6%, respectively (p = 0.44). Conclusions During the COVID-19 lockdown the guideline for patients in Israel was to avoid unnecessary hospital visits. Since patients tended to avoid the OER rather uniformly regardless of their specific eye condition, determining the risk-benefit of such recommendations and identifying high-risk sub-populations are critical public health issues.

Specificities of pediatric ocular emergencies before and during the COVID-19 era: A retrospective comparative study in an eye-related emergency department in Paris

“…We report a 46% decrease in total number of visits during the lockdown period in our eye-related emergency department. A decrease in the absolute number of presentations of the same magnitude was reported in Europe [5] , the United States [ 6 , 7 ], and Israel [8] at the onset of the pandemic.…”

“…The changing local characteristics of lockdown policies and enforcement added a level of complexity. In a single-center Israeli retrospective study of the general population, the patient demographics, distribution of diagnoses, and rate of admissions during COVID-19 did not change as compared with pre-COVID-19 data [8] . A multicenter Italian retrospective study of the general population found a larger proportion of males, lower proportion of eye inflammation, headaches, conjunctivitis, and blepharitis, and a higher proportion of trauma-related diagnoses during COVID-19 than during the pre-COVID-19 period but no significant change in the rate of admissions [5] .…”