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American Academy of Ophthalmology Provides COVID-19 Guidance for Outpatient Clinics and Elective Surgery

Doctors are only providing urgent and emergency care
Doctors are only providing urgent and emergency care

UPDATE: MARCH 18, 2020 -- Due to the COVID-19 pandemic, the American Academy of Ophthalmology (AAO) now finds it essential that all ophthalmologists cease providing any treatment other than urgent or emergent care immediately.

The American Academy of Ophthalmology strongly recommends that all ophthalmologists provide only urgent or emergent care. This includes both office-based care and surgical care. The Academy recognizes that “urgency” is determined by physician judgment and must always take into account individual patient medical and social circumstances.

To view AAO’s additional information on coronavirus (COVID-19) for eye doctors and patients, which is updated daily, click here.

March 17, 2020 -- In response to the state of national emergency declared at the federal level, particularly as COVID-19 progresses in a given community, ophthalmologists should seriously consider both the intensity of clinic scheduling and the issue of elective surgeries, particularly in elderly patients and those with chronic medical conditions, according to new guidance from the American Academy of Ophthalmology (AAO).

The Centers for Disease Control and Prevention (CDC) has issued mitigation plans, including a recommendation for the cancellation or reduction of elective procedures in health care settings, for the following communities: Santa Clara, California; New Rochelle, New York; Florida; Massachusetts; and Seattle, Washington.

Outpatient clinics

Office waiting areas often violate social distancing guidelines due to the number of patients and staff in confined spaces. Ophthalmology practices should reconfigure examination schedule templates to decompress their waiting areas and consider alternatives such as encouraging patients to wait in other locations (e.g., their cars or outdoor spaces). Mobile phone calls or other approaches can be used by office staff to notify patients when they should return to the office.

Elective surgical procedures

The American Academy of Ophthalmology supports the recommendation from American College of Surgeons regarding minimizing, postponing or canceling elective surgeries, while recognizing that the timing may vary by community and disease indication. In addition, circumstances vary for hospitals, hospital-based outpatient surgery departments, freestanding ASCs and office-based procedures. However, all ophthalmologists should be prepared to adjust their surgical volumes as local circumstances dictate. Even outpatient ASC-based procedures may expose other patients and health care workers to virus shed from asymptomatic patients. Elective surgical procedures also deplete scarce personal protective equipment, including but not limited to masks and face shields.

The Coronavirus and Ophthalmology

Two recent reports suggest the virus can cause conjunctivitis (inflammation of the conjunctiva of the eye, also called 'pink eye').

  • In a Journal of Medical Virology study of 30 patients hospitalized for COVID-19 in China, 1 had conjunctivitis. That patient — and not the other 29 — had SARS-CoV-2 in their ocular secretions. This suggests that SARS-CoV-2 can infect the conjunctiva and cause conjunctivitis, and virus particles are present in ocular secretions.

Source: EyeWire News

Last reviewed on April 13, 2020

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