The global impact of Covid-19 on eyecare and eye health – Part 1

The emergence of the COVID-19 pandemic has had an immediate and dramatic impact on eyecare. Even now, more than a year since the emergence of this public health crisis, Covid-19 continues to overwhelm healthcare systems and resources around the globe. The highly infectious nature, hospitalisation and mortality rates associated with COVID-19 has impacted clinical care for many life-threatening conditions and has quite naturally shifted concerns away from non-fatal conditions that cause only morbidity or disability, eye disorders included.

Eyecare service impact

With the suspension or delay of optometric, medical, surgical, screening and clinical trial activities, COVID-19 has fundamentally reshaped ophthalmic clinical practice at every level. The need to balance our patients’ long-term and short-term eye health needs against the risk of them (and us) suffering health- and life-threatening complications from COVID-19 has had a significant influence on the way we practice, with eye services having to be reconfigured in ways which required practitioners to make decisions about whom to see and how.

Challenges and Opportunities

The transmission risks posed during the eye examination can be readily managed. Other challenges, however, might be more difficult to counter. Patient behaviour, for example, may change fundamentally post-COVID. During the restrictions over the past year, more consumers purchased goods online, including eyeglasses and contact lenses than ever before. Online retailers experienced significant growth, and traditional practices were disadvantaged by the challenges of seeing fewer patients while managing the costs of maintaining a physical location.

Online prescription renewal is likely to continue to appeal to consumers who want to obtain glasses or contact lenses without undergoing a comprehensive eye examination due to perceived inconvenience, cost or risk of contracting an illness. Optometrists can expect these technologies to improve in simplicity, speed and accuracy, and thereby facilitate rapid growth in the online vision correction market.

Online prescription renewal is likely to continue to appeal to consumers who want to obtain glasses or contact lenses without undergoing a comprehensive eye examination due to perceived inconvenience, cost or risk of contracting an illness.

Enhanced Professional Services

Online sales companies cannot compete in the professional services realm, so expanding the range of specialised services available can protect against online sales competition. The emphasis should be on improving the overall quality of care for patients by expanding ocular health and disease services to develop additional recurrent sources of revenue that are not reliant on refraction-based sales. Opportunities certainly exist for optometry to provide enhanced services for low vision, vision therapy, in-clinic eyelid treatments for meibomian gland expression, specialty contact lenses and myopia management.

Teleoptometry Services

Social distancing measures will remain a part of daily life for the foreseeable future. COVID-19 has affected both the ability and desire of patients to travel to a clinic appointment. Consequently, eyecare has evolved rapidly to handle the newly exacerbated mismatch between capacity and demand, including the provision of remote monitoring and virtual clinics. Although patients might previously have expressed concern at the lack of an interaction with a specialist in “virtual clinics”, an unintended consequence of the COVID-19 pandemic is that patient perceptions have now changed due to concerns about the risk associated with travel and attendance, especially in a hospital environment.

Telephone and video consultations have therefore become routine. The fact that patients have accepted and readily adapted to this mode of practice could introduce a shift in the field and impact the direction optometry moves in. Technical solutions are already emerging, with various platforms such as Ocuco’s Virtual Consult already in existence.

Virtual Consultations: over 32% of patients surveyed in 2020 by the Vision Council* stated that they wanted their eyecare practitioner to offer virtual vision care 

COVID-19 has highlighted the vulnerability of the optical element of the profession and it has forced all of us to evaluate our priorities and compelled us to look at different ways of operating. While some of the enforced changes will likely be rolled back once the various waves of the pandemic recede, others are poised to endure, transforming how optometry is taught, practised and experienced in multiple ways. We have a once in a generation chance to transform what we do, to focus on meeting patient needs through innovation and partnership with ophthalmology.

Enhanced services to help bridge the gap between capacity and demand in the face of the increasing prevalence of sight-threatening diseases such as age-related macular degeneration, myopic maculopathy, glaucoma and diabetic retinopathy can ensure that optometry remains relevant and at the heart of eyecare service delivery in a new technological era which is less focussed on refraction and optical appliance sales.

Useful Resources

A virtual hub has been established to share helpful resources on the coronavirus pandemic for optometry students, practising optometrists, and practice owners.  The American Optometric Association has also produced some useful resources for optometrists. Check them out here.

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In Part 2, we will examine ocular and general health considerations, exploring the potential impact of COVID-19 on patients as a consequence of eyecare service disruption.

*www.thevisioncouncil.org/system/tdf/TVC-VisionWatch-COVID-19-April-2020-Final-Report.pdf?file=1

James Loughman is the Clinical Research Director for Ocuco Ltd. An Optometrist with more than 20 years of clinical, academic, research and management experience. James is also presently the Director of the Centre for Eye Research Ireland, a research facility based in Technological University Dublin, the same university where he received his PhD in 1997. James oversees a portfolio of research including technology development and big data analytics projects alongside various clinical trials for the control of myopia, glaucoma and other blinding conditions.