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Ophthalmology Practices Hit Hard by COVID-19 Closures, Changes

“We are surviving, and we are keeping almost all of our employees still employed. We are applying for multiple programs including the payroll protection program and some state emergency funding as well,” Bhavsar said.

To find out how the pandemic is affecting ophthalmologists in private practice, AAO surveyed 2500 members from April 9-13, 2020. Of those, 400 (16%) replied.

Overall, AAO reported that 89% of respondents are applying for payroll protection through the Coronavirus Aid, Relief, and Economic Security (CARES) Act and other sources. Most predict that their practices will be “smaller, financially unhealthy, or both by the end of the year” without significant federal grants and loans.

Only 6% of respondents believed they would be back to pre-COVID levels for size, volume, and financial health.

Elective Visits Canceled, Volume Down

Ophthalmologists are limiting patients they see in clinic to those with urgent and emergent situations and are honing new skills to help patients using telehealth technologies.

At the University of Iowa in Iowa City, for example, they reduced the number of patients they see in the ophthalmology clinic in mid-March and are seeing about 15% of their normal clinic volume, said Keith D. Carter, MD, professor of ophthalmology & visual sciences, University of Iowa.

Practices focused on surgical procedures have been particularly hard hit, according to Julia A. Haller, MD, ophthalmologist-in-chief at Wills Eye Hospital, Philadelphia, Pennsylvania.

“With all the restrictions, we’re now only seeing patients for urgent and emergent issues or doing surgical procedures that are urgent or emergent, and that means we’re putting off a lot of people who need surgery. Now that we’re some weeks into the pandemic, we’ve got a whole cadre of people who really need to be seen even though they don’t have frank emergencies, but the longer they’re put off the more they become emergencies,” Haller explained.

This is a trend that is being seen across numerous medical specialties, Haller noted. In ophthalmology, safety and quality of life also suffer for patients with impaired vision, and vision loss can become permanent, she said.

Operating room volume is similarly very low due to deferred procedures at Massachusetts Eye and Ear, Lorch said, though they too are treating emergent conditions, such as ruptured globes and urgent retinal detachment. They also are still seeing patients at risk for vision loss, but screening patients for potential symptoms of COVID-19 prior to seeing them and again when they arrive for their visit.

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