The American Academy of Ophthalmology (AAO) has updated COVID-19 guidance for ophthalmologists and other eyecare providers to help further reduce the spread of the novel coronavirus SARS-CoV-2 within communities.
The Academy’s Board of Trustees met on March 18, and at that meeting voted unanimously to strongly urge all ophthalmologists and other eye care providers against operating on individuals for routine or elective cases and from evaluating patients that are considered to have routine care.
The decision came after the US Centers of Disease Control and Prevention recommended that eyecare providers and dentists stop all routine care, commented Anne L. Coleman, MD, PhD, University of California, Los Angeles (UCLA), who is president of the AAO, speaking at a press conference held March 20.
AAO considered the new guidance to be necessary and important because of the close contact between patients, clinicians, and members of staff in the eye care provider’s office. Typically, there is less than 3-feet between the patient and provider during an eye examination, for example, she explained.
Coleman noted that patients needing routine eye care are currently considered to be those who can wait approximately 2 months for an evaluation because they are not deemed at imminent risk of vision loss without either an eye examination or treatment intervention during this time.
By contrast, patients needing urgent care are those who could not wait 2 months for an eye examination or treatment intervention without the risk of vision loss, she added. Eye care providers can see these patients but should follow specific protocols implemented by their own offices and local health systems.
AAO also reported that the Centers for Medicare & Medicaid Services and the US Department of Health & Human Services have also expanded telehealth benefits during the COVID-19 outbreak for patients with or without symptoms associated with the disease. This allows eye care providers to offer services to patients via telephone, internet-based consultation, or telemedicine exam, to help reduce the number of office visits.
Coleman noted that at her institution (UCLA) patients are being prescreened by telephone before a visit to identify those with symptoms associated with COVID-19. Any patients who report having fever, cough, or respiratory illness are advised to visit their primary care physician’s office or the emergency room instead of visiting their eye care provider.
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Individuals who are prescreened by telephone and considered fit for examination can visit their eye care provider where they will be screened again by members of staff wearing personal protective equipment (PPE) to ensure they are healthy enough to be examined.
Eye care providers can also take various other precautions to reduce the risk of transmitting SARS-CoV-2. These include using protective breath shields on slit lamps, said Coleman. If a patient has respiratory symptoms, the patient, provider, and staff should wear masks, she added.