Opticians switch to telehealth amid pandemic

Phone calls, virtual visits replace in-person eye care

Adjusting to new guidelines

The College of Optometrists, the professional body for optometry in the United Kingdom, has laid out a temporary set of guidelines for social distancing, increased privacy measures and remote patient care during the COVID-19 pandemic.

As of 1 April 2020, the College is advising optometrists to use their best judgment in determining which patients should be seen face-to-face, and if any typical or modified treatment should follow.

Smaller high-street practices that are now closed are being asked to refer patients to a nearby practice that can see emergency patients. Patients with symptoms of COVID-19 should not be seen at the practice, and instead be redirected to a hospital.

Mr Paul Ursell, a consultant ophthalmologist based in Surrey, UK, noted that many NHS eye doctors are even being reassigned to other parts of the hospital, in an ongoing effort to aid COVID-19 care.

During this time of isolation, he has noticed a drop in optical demand, but a rise in remote care within practices.

Most routine eye care appointments rescheduled

“Telehealth has rapidly become widely prevalent throughout the eye field during the COVID crisis,” said Ursell, a member of All About Vision UK’s editorial advisory board. 

“For routine care, most appointments have been rescheduled to later in the year,” he explained. “For patients where there is a need for ongoing care, such as post-op visits or intravitreal injections, phone calls are made to the patients prior to their consultation.

“If face-to-face treatment is needed, a streamlined visit is organised to reduce contact time with the patient as much as possible.”

The Royal College of Ophthalmologists (RCOphth) has also developed temporary guidelines for ophthalmology practices.

Similarly, they advise all in-person appointments be postponed unless the patient is at risk of “rapid, significant harm” should the appointment be delayed.

As of 28 March 2020, screenings like those associated with diabetic retinopathy should also be delayed, except in the case of high-risk patients. Pregnancy is given as one example of a high-risk scenario.

Proper distancing measures are advised for patients who require in-office exams or treatment. Offices are asked to minimize wait times, keep patient-staff interactions brief, and ensure 2-metre personal distances, except when close examination is unavoidable.

The temporary rise of virtual consultations

As COVID-19 lockdowns continue, video consultations are starting to surface at high-street practices and private hospitals all over Europe. These virtual visits can be as simple as a FaceTime or Skype call, while others utilize more robust software developed specifically for medicine.

Virtual visits are also being offered by select NHS branches, such as the Moorfields Eye Hospital trust in London.

Currently, Moorfields clinicians are using video conferencing software called Attend Anywhere to conduct these confidential consultations. Appointments can be held through almost any internet-connected PC, Mac, iOS or Android device with a camera.

While these video sessions aren’t meant to replace an in-person ophthalmologic exam, they can provide critical input from a clinician — helping the patient decide whether emergency care is needed.

“Local colleagues are mainly dealing with repeat contact lens prescriptions and queries about acute eye care,” Ursell said.

“Mostly they are redirecting the clinical queries to the local eye departments, or doing what they can themselves over the phone,” he said. “They are also arranging for new glasses to be delivered to or collected by clients who have lost or broken their current frames.”

Ursell believes telehealth and long-distance care will become even more prominent as measures of social distancing continue. He is currently in the process of updating his own private practice website to reflect this.

Like professionals in nearly every other field, opticians are reacting to the best of their ability to the transformative, albeit temporary, nature of their industry.

By Adam Debrowski