Delhi Journal of Ophthalmology

Effect of Covid-19 on Ophthalmology

Vinod Kumar
(MS DNB MNAMS FRCS)
Editor, Delhi Journal of Ophthalmology
Associate Professor, Vitreo-retina Services
Dr. Rajendra Prasad Centre for Ophthalmic Sciences,
All India Institute of Medical Sciences (AIIMS), New Delhi

Corresponding Author:

Vinod Kumar
(MS DNB MNAMS FRCS)
Editor, Delhi Journal of Ophthalmology
Associate Professor, Vitreo-retina Services
Dr. Rajendra Prasad Centre for Ophthalmic Sciences,
All India Institute of Medical Sciences (AIIMS), New Delhi

Published Online: 08-OCT-2020

DOI:http://dx.doi.org/10.7869/djo.556

Abstract

Keywords :

Since its first case in December 2019, Covid-19 has spread to almost all parts of world with over 26 million cases and over 850 thousand deaths recorded as on 5th September 2020. Of these, over 4 million cases have been recorded in India alone. The new cases continue to rise in India with each week witnessing a new high. Fortunately death rates seems to have reduced and has been ascribed to decreased virulence of the Corona virus as well as better understanding  and management of the disease. In spite of all this, Covid-19 remains a major health concern especially amongst the predisposed. 

While Covid-19 has exposed the weaknesses of even best health care systems of the world, it has been double whammy for developing and underdeveloped countries. Already scanty public sector health services have been diverted towards Covid-19 putting further stress on this sector. The cost of care has increased in private sector due to Covid-19. A section of society which could earlier afford private sector, is therefore no longer able to. Loss of jobs and pay cuts due to Covid-19 have further added to the situation. This has made Covid-19 times extremely difficult to have any other disease or morbidity. Ophthalmic patients have been no different and have been affected immensely.  Though most ophthalmic disorders do not affect longevity of life, visual loss due to unavailability of care can have long term social, economic and mental implications.

While patients continued to sought care for most emergencies and acute disorders, it was the patients with sub-acute and chronic disorders who have suffered the most. Some of the patients who are affected the most include retinopathy of prematurity (ROP), neovascular age related macular degeneration (AMD), diabetic retinopathy and retinal detachment. Many of these patients actually fall in the high risk category for Covid-19. Ever since the opening of outpatient services at our institute, we continue to see more and more and patients. It has been heart wrenching to see so many premature kids with stage 5 ROP, previously well controlled neovascular AMD patients with irreversible loss of vision due to lack of intravitreal injections and retinal detachment patients with advanced stages of proliferative vitreoretinopathy (PVR). While lack of therapy may not affect macular edema of vascular disorders much over short term, proliferative retinopathies especially proliferative diabetic retinopathy does progress significantly. Uveitis and glaucoma patients are another subset of patients who need regular monitoring. Given that most patients are on chronic treatment and understand their disease and treatment a bit, impact may not have been that great. 

With no sight to the availability of vaccine and end of pandemic and several regions of country witnessing a second wave, this impact of Covid-19 on the morbidity and mortality of other disease conditions is bound to increase. Unless the policy makers work on this aspect of health care services and patient education, the impact is going to be felt for several coming years.

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Kumar VEffect of Covid-19 on Ophthalmology.DJO 2020;31:6

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Kumar VEffect of Covid-19 on Ophthalmology.DJO [serial online] 2020[cited 2020 Dec 3];31:6. Available from: http://www.djo.org.in/articles/31/1/Effect-of-Covid-19-on-Ophthalmology.html