Ophthalmology Practice During the Coronavirus Disease 2019 Pandemic: The University of Pittsburgh Experience in Promoting Clinic Safety and Embracing Video Visits

Andrew M Williams, Gagan Kalra, Patrick W Commiskey, Eve M R Bowers, Brian R Rudolph, Mary D Pitcher, Kunal K Dansingani, Vishal Jhanji, Ken K Nischal, José-Alain Sahel, Evan L Waxman, Roxana Fu, Andrew M Williams, Gagan Kalra, Patrick W Commiskey, Eve M R Bowers, Brian R Rudolph, Mary D Pitcher, Kunal K Dansingani, Vishal Jhanji, Ken K Nischal, José-Alain Sahel, Evan L Waxman, Roxana Fu

Abstract

The coronavirus disease 2019 pandemic has led to widespread change as public health strategies for containment have emphasized social distancing and remaining at home. These policies have led to downscaled clinic volumes, cancellation of elective procedures, enhanced personal protective strategies in the clinic, and adoption of telemedicine encounters. We describe the evidence-based practical approach taken in our ophthalmology department to continue delivering eye care during the pandemic by rescheduling visits, enhancing clinic safety, and adopting virtual video encounters.

Keywords: COVID-19; Coronavirus; Coronavirus disease 2019; Patient triage; Practical approach; Prevention; Safety; Teleophthalmology; Video visits; Web-based vision testing.

© The Author(s) 2020.

Figures

Fig. 1
Fig. 1
Rescheduling triage results by subspecialty for patients with appointments from March 19 through April 30, 2020. Patients determined to be at high risk of eye disease progression maintained their original appointments as scheduled (“in-person”). Those at moderate risk were offered a video visit for virtual check-in, and low-risk patients had appointments canceled, with plans for rescheduling in 3–6 months. Patient risk stratification was determined by each individual provider. CES, comprehensive eye service; motil, adult strabismus and motility service; neuro-oph, neuro-ophthalmology service; oculoplast, oculoplastic surgery service
Fig. 2
Fig. 2
Rescheduling triage results by visit type for patients with appointments from March 19 through April 30, 2020. Results reflect visits from the retina and glaucoma services. New, new patient to the practice; Follow up, established patient seeking a medical visit; Postop, visit within the 90-day postoperative period; Preop, patient visit to plan for surgery, Procedure, patient scheduled for a procedure-only visit with a provider
Fig. 3
Fig. 3
Personal protective equipment recommendations by patient screen status. The left column indicates whether the patient has screened positive or negative for exposure to a known contact with COVID-19 or report of fever, cough, or dyspnea
Fig. 4
Fig. 4
Webpage to assess near visual acuity for video visits, available at https://farsight.care

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