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2.
J Coll Physicians Surg Pak ; 30(1): S32-S34, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33650422

RESUMO

Ophthalmology is a specialty which involves close contact with patients. Personal protective equipment (PPE) along with modifications in examination techniques and equipment are needed to avoid spread of coronavirus infectious disease (COVID-19) to health professionals. This communication aims to highlight and critically analyse the measures suggested to control this spread. We also highlighted our experience with protective gear modifications. As with any practice, triage is cornerstone. Use of disinfectants, good personal hygiene practices and PPE for patients and staff, must be adopted for safe ophthalmology practices. Key Words: COVID-19, Ophthalmology, Personal protective equipment (PPE).


Assuntos
/epidemiologia , Oftalmopatias/epidemiologia , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Oftalmologia/métodos , Pandemias , Equipamento de Proteção Individual , /transmissão , Comorbidade , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos
3.
BMC Ophthalmol ; 21(1): 139, 2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33743634

RESUMO

BACKGROUND: To minimize the risk of viral transmission, ophthalmology practices limited face-to-face encounters to only patients with urgent and emergent ophthalmic conditions in the weeks after the start of the COVID-19 epidemic in the United States. The impact of this is unknown. METHODS: We did a retrospective analysis of the change in the frequency of ICD-10 code use and patient volumes in the 6 weeks before and after the changes in clinical practice associated with COVID-19. RESULTS: The total number of encounters decreased four-fold after the implementation of clinic changes associated with COVID-19. The low vision, pediatric ophthalmology, general ophthalmology, and cornea divisions had the largest total decrease of in-person visits. Conversely, the number of telemedicine visits increased sixty-fold. The number of diagnostic codes associated with ocular malignancies, most ocular inflammatory disorders, and retinal conditions requiring intravitreal injections increased. ICD-10 codes associated with ocular screening exams for systemic disorders decreased during the weeks post COVID-19. CONCLUSION: Ophthalmology practices need to be prepared to experience changes in practice patterns, implementation of telemedicine, and decreased patient volumes during a pandemic. Knowing the changes specific to each subspecialty clinic is vital to redistribute available resources correctly.


Assuntos
Centros Médicos Acadêmicos/tendências , Assistência Ambulatorial/tendências , Oftalmopatias/diagnóstico , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Oftalmologia/tendências , Padrões de Prática Médica/tendências , /transmissão , Controle de Doenças Transmissíveis , Humanos , Classificação Internacional de Doenças , Oftalmologia/métodos , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Telemedicina/métodos , Estados Unidos
5.
BMJ ; 372: m4979, 2021 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-33536186

RESUMO

The uveitides are a heterogeneous group of diseases characterized by inflammation inside the eye. The uveitides are classified as infectious or non-infectious. The non-infectious uveitides, which are presumed to be immune mediated, can be further divided into those that are associated with a known systemic disease and those that are eye limited,-ie, not associated with a systemic disease. The ophthalmologist identifies the specific uveitic entity by medical history, clinical examination, and ocular imaging, as well as supplemental laboratory testing, if indicated. Treatment of the infectious uveitides is tailored to the particular infectious organism and may include regional and/or systemic medication. First line treatment for non-infectious uveitides is corticosteroids that can be administered topically, as regional injections or surgical implants, or systemically. Systemic immunosuppressive therapy is used in patients with severe disease who cannot tolerate corticosteroids, require chronic corticosteroids at >7.5 mg/day prednisone, or in whom the disease is known to respond better to immunosuppression. Management of many of these diseases is optimized by coordination between the ophthalmologist and rheumatologist or internist.


Assuntos
Oftalmologia/métodos , Uveíte/diagnóstico , Corticosteroides/administração & dosagem , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Técnicas de Diagnóstico Oftalmológico , Humanos , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Uveíte/classificação , Uveíte/tratamento farmacológico , Uveíte/fisiopatologia
6.
Indian J Ophthalmol ; 69(3): 714-718, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33595507

RESUMO

Purpose: The aim of this study was to describe the experience of teleconsultations addressed at our hospital in India during the ongoing coronavirus (COVID-19) lockdown. Methods: This cross-sectional hospital-based study included 977 teleconsultations presenting between April 1st and May 31, 2020. A two-level protocol was implemented to triage the calls. Results: Overall, 977 teleconsultation were addressed. Of the 621 teleconsultation addressed the most common queries were related to redness/pain/ watering/blurred vision/itching/irritation (52.49%), followed by queries related to medications (28.01%), appointments (18.84%) & 0.64% cited an emergency need to visit the hospital due to sudden loss of vision. The majority of the queries were directed to the department of cornea (58.93%) followed by retina (16.26%), cataract (13.04%), glaucoma (10.14%) & pediatric ophthalmology (1.61%). The most common advice given to the patient was related to medications (47.66%) followed by appointment-related queries (31.72%) & fixing of surgical appointment (20.61%). Among the 356 preterm babies that were screened, 57 (16.01%) were diagnosed with retinopathy of prematurity (ROP). Of them 3 required laser and 3 were given injection. Conclusion: Teleconsultation is here to stay beyond the pandemic. WhatsApp was the preferred modality of communication for us. Teleophthalmology has given us insights to use this evolving technology to reach out to the population at large to provide eye care services. We believe that this mode of teleophthalmology has helped us in providing feasible eye care to the patients.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis/métodos , Oftalmologia/métodos , Quarentena , Telemedicina/métodos , Centros de Atenção Terciária/estatística & dados numéricos , Transtornos da Visão/epidemiologia , Comorbidade , Estudos Transversais , Assistência à Saúde/métodos , Humanos , Índia/epidemiologia , Pandemias , Estudos Retrospectivos
7.
Indian J Ophthalmol ; 69(2): 385-390, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33380619

RESUMO

Purpose: The objective of this study was to identify and validate smartphone-based visual acuity (VA) apps that can be used in a teleophthalmology portal. Methods: The study was conducted in three phases: A survey to investigate if the SmartOptometry App was easy to download, understand and test (phase I), an in-clinic comparison of VA measured in a random testing order with four tools namely COMPlog, Reduced Snellen near vision, Peek Acuity (Distance VA) and SmartOptometry (Near VA) (phase II) and a repeatability study on these 4 tools by measuring VA again (phase III). The study recruited the employees of our institute and adhered to the strict COVID-19 protocols of testing. Results: Phase I Survey (n = 40) showed 90% of participants used android phones, 60% reported that instructions were clear, and all users were able to self-assess their near VA with SmartOptometry App. Phase II (n = 68) revealed that Peek Acuity was comparable to COMPlog VA (P = 0.31), however SmartOptometry was statistically significantly different (within 2 log MAR lines) from Reduced Snellen near vision test, particularly for young (n = 44, P = 0.004) and emmetropic (n = 16, P = 0.04) participants. All the 4 tests were found to be repeatable in phase III (n = 10) with a coefficient of repeatability ≤0.14. Conclusion: Smartphone-based apps were easy to download and can be used for checking patient's distance and near visual acuity. An effect of age and refractive error should be considered when interpreting the results. Further studies with real-time patients are required to identify potential benefits and challenges to solve.


Assuntos
/epidemiologia , Aplicativos Móveis , Oftalmologia/métodos , Erros de Refração/diagnóstico , Telemedicina/métodos , Testes Visuais/métodos , Acuidade Visual , Adulto , Idoso , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Erros de Refração/epidemiologia , Reprodutibilidade dos Testes , Smartphone , Adulto Jovem
8.
Curr Opin Ophthalmol ; 32(2): 75-82, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315725

RESUMO

PURPOSE OF REVIEW: The current article reviews the impact of the coronavirus disease 2019 (COVID-19) pandemic on the delivery of ophthalmic, and specifically, glaucoma care. RECENT FINDINGS: Literature from the review period includes case series demonstrating the presence of severe acute respiratory syndrome coronavirus 2 RNA in the conjunctival secretions of patients with laboratory-confirmed COVID-19. The global ophthalmology community published reports outlining the enhanced infection control measures undertaken by different institutions around the world to mitigate transmission of the novel coronavirus. Telemedicine has been increasingly implemented in glaucoma practices to reduce in-office patient volume. New data regarding the efficacy and feasibility of tools for home monitoring of intraocular pressure, virtual visual field testing, and remote disc photography are reviewed. SUMMARY: COVID-19 has posed a global public health threat due to the severity of its contagion and associated morbidity and mortality. Glaucoma specialists have responded to the pandemic with innovative modifications to reduce viral transmission and optimize patient and staff safety in the office and operating room. The role of teleglaucoma has expanded and will continue to evolve as remote diagnostic devices undergo further refinement and validation.


Assuntos
/epidemiologia , Gerenciamento Clínico , Glaucoma/terapia , Oftalmologia/métodos , Pandemias , Telemedicina/métodos , Comorbidade , Glaucoma/epidemiologia , Humanos
10.
Niger Postgrad Med J ; 27(4): 268-270, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33154277

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a highly infectious coronavirus, has been rapidly spreading after its surge in China in December 2019. It is currently a global pandemic. A myriad of transmission routes have been documented, however established thus far, are respiratory droplet, contact and airborne transmissions. Susceptible persons at proximity, usually within 1-2 m, to infected persons are largely at risk of being infected. Unfortunately, health workers usually evaluate patients within this distance. Eye care professionals (ECPs) are faced with a higher risk scenario of being infected as they undertake routine clinical eye examination procedures at a close face-to-face proximity to patients, which place them at a high risk of respiratory droplets and aerosolised particles, particularly from asymptomatic and pre-symptomatic carriers. The slit lamp examination procedure is typically at a distance of between 0.25 m and 0.5 m. While undertaking certain procedures on the slit lamp, such as gonioscopy and slit lamp indirect ophthalmoscopy, the ECP holds the accessory lenses either directly on the patient's eye or at about 5-10 cm from the patient's face, respectively. The authors found it pertinent to articulate this narrative review article to guide slit lamp examination practice by ECPs during routine ophthalmic evaluation, with a view to reducing the spread of SARS-CoV-2 to ECPs. In conclusion, ECPs are at increased risk of infection due to high-risk scenarios for routine slit lamp examination procedures of the eye. Adherence to standard precautionary measures with slit lamp use is highly recommended.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Oftalmologia/métodos , Optometria/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Microscopia com Lâmpada de Fenda , Betacoronavirus , Humanos , Nigéria , Risco
11.
PLoS One ; 15(10): e0240421, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031477

RESUMO

OBJECTIVE: To evaluate the microbial loading in aerosols produced after air-puff by non-contact tonometer (NCT) as well as the effect of alcohol disinfection on the inhibition of microbes and thus to provide suggestions for the prevention and control of COVID-19 in ophthalmic departments of hospitals or clinics during the great pandemics. METHODS: A cross-sectional study was carried out in this study. A NIDEK NCT was used for intraocular pressure (IOP) measurement for patients who visited Department of Ophthalmology in Qilu Hospital of Shandong University during March 18-25 2020. After ultra-violate (UV) light disinfection, the room air was sampled for 5 minutes. Before and after alcohol disinfection, the air samples and nozzle surface samples were respectively collected by plate exposure method and sterile moist cotton swab technique after predetermined times of NCT air-puff. Microbial colony counts were calculated after incubation for 48 hours. Finally, mass spectrometry was performed for the accurate identification of microbial species. RESULTS: Increased microbial colonies were detected from air samples close to NCT nozzle after air-puff compared with air samples at a distance of 1 meter from the nozzle (p = 0.001). Interestingly, none microbes were detected on the surface of NCT nozzle. Importantly, after 75% alcohol disinfection less microbes were detected in the air beside the nozzle (p = 0.003). Microbial species identification showed more than ten strains of microbes, all of which were non-pathogenic. CONCLUSION: Aerosols containing microbes were produced by NCT air-puff in the ophthalmic consultation room, which may be a possible virus transmission route in the department of ophthalmology during the COVID-19 pandemic. Alcohol disinfection for the nozzle and the surrounding air was efficient at decreasing the microbes contained in the aerosols and theoretically this prevention measure could also inhibit the virus. This will give guidance for the prevention of virus transmission and protection of hospital staff and patients.


Assuntos
Microbiologia do Ar , Álcoois/química , Infecções por Coronavirus/prevenção & controle , Desinfetantes/química , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Tonometria Ocular/métodos , Aerossóis/química , Betacoronavirus/fisiologia , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Hospitais , Humanos , Oftalmologia/métodos , Pneumonia Viral/epidemiologia
12.
Eur Rev Med Pharmacol Sci ; 24(18): 9705-9711, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33015816

RESUMO

OBJECTIVE: Since the COVID-19 outbreak, otolaryngologists, ophthalmologists and dentists have been severely affected, both for the transmission routes and for the diagnostical and therapeutic procedures typical of these disciplines. MATERIALS AND METHODS: In this article, we discuss the transmission routes, the potential risk of contagion for patients and healthcare providers during procedures, and comment on the changes that will affect head and neck clinical practice in the future of outpatient and surgical activities. RESULTS: Otolaryngologists, ophthalmologists and dentists are at high risk for infection contagion and spread because they perform diagnostic and therapeutic procedures that generate aerosol and droplets thus facilitating virus transmission. Furthermore, examination involves close doctor-patient contact and otolaryngologists and dentists have to remove patient's protective devices during the visit. CONCLUSIONS: Special attention to prevention protocols for diagnostic and therapeutic procedures and the use of protective equipment is of utmost importance to limit contagion and prevent a new virus spread in the near future.


Assuntos
Infecções por Coronavirus/prevenção & controle , Clínicas Odontológicas/métodos , Oftalmologia/métodos , Otolaringologia/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/transmissão , Previsões , Humanos , Pneumonia Viral/transmissão
13.
J Diabetes Res ; 2020: 9036847, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33123599

RESUMO

Recently, telemedicine has become remarkably important, due to increased deployment and development of digital technologies. National and international guidelines should consider its inclusion in their updates. During the COVID-19 pandemic, mandatory social distancing and the lack of effective treatments has made telemedicine the safest interactive system between patients, both infected and uninfected, and clinicians. A few potential evidence-based scenarios for the application of telemedicine have been hypothesized. In particular, its use in diabetes and complication monitoring has been remarkably increasing, due to the high risk of poor prognosis. New evidence and technological improvements in telemedicine application in diabetic retinopathy (DR) have demonstrated efficacy and usefulness in screening. Moreover, despite an initial increase for devices and training costs, teleophthalmology demonstrated a good cost-to-efficacy ratio; however, no national screening program has yet focused on DR prevention and diagnosis. Lack of data during the COVID-19 pandemic strongly limits the possibility of tracing the real management of the disease, which is only conceivable from past evidence in normal conditions. The pandemic further stressed the importance of remote monitoring. However, the deployment of device and digital application used to increase screening of individuals and monitor progression of retinal disease needs to be easily accessible to general practitioners.


Assuntos
Infecções por Coronavirus/epidemiologia , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/terapia , Pandemias , Pneumonia Viral/epidemiologia , Telemedicina , Betacoronavirus/fisiologia , Análise Custo-Benefício , Retinopatia Diabética/epidemiologia , Humanos , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Programas de Rastreamento/organização & administração , Programas de Rastreamento/tendências , Oftalmologia/economia , Oftalmologia/métodos , Oftalmologia/organização & administração , Oftalmologia/tendências , Telemedicina/economia , Telemedicina/organização & administração , Telemedicina/normas , Telemedicina/tendências
14.
Middle East Afr J Ophthalmol ; 27(2): 91-99, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874041

RESUMO

PURPOSE: This study compares a web-based teleophthalmology assessment with a clinical slit lamp examination to screen for diabetic retinopathy (DR) and age-related macular degeneration (AMD) among diabetic patients in a rural East African district. METHODS: Six hundred and twelve eyes from 306 diabetic patients underwent both a clinical slit lamp examination and a teleretina (TR) assessment by an experienced ophthalmologist. Both assessments were compared for any DR and AMD using the early treatment diabetic retinopathy study and age-related eye disease study grading scales, respectively. RESULTS: Of the 612 TR assessment photos, 74 (12%) were deemed ungradable due to media opacities, poor patient cooperation, or unsatisfactory photographs. The ability to detect DR and AMD showed a fair agreement (kappa statistic 0.27 and 0.23, respectively) between the TR and clinical slit lamp examination. Relative to a clinical slit lamp evaluation, a positive TR diagnosis carried a 75.0% positive predictive value when diagnosing DR and a 27.3% positive predictive value when diagnosing AMD. A negative TR diagnosis carried a 97.2% negative predictive value for the diagnosis of DR and a 98.1% negative predictive value for the diagnosis of AMD. CONCLUSION: When comparing TR assessments to clinical slit lamp examinations to diagnose DR and AMD, there was a fair agreement. Although further validation is needed, the TR approach provides a promising method to diagnose DR and AMD, two major causes of ocular impairment worldwide.


Assuntos
Retinopatia Diabética/diagnóstico , Degeneração Macular/diagnóstico , Oftalmologia/métodos , Exame Físico , Consulta Remota/métodos , Telemedicina/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus , Feminino , Humanos , Quênia , Masculino , Pessoa de Meia-Idade , Microscopia com Lâmpada de Fenda
15.
Curr Opin Ophthalmol ; 31(5): 329-336, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32740060

RESUMO

PURPOSE OF REVIEW: To review the current status of artificial intelligence systems in ophthalmology and highlight the steps required for clinical translation of artificial intelligence into personalized health care (PHC) in retinal disease. RECENT FINDINGS: Artificial intelligence systems for ophthalmological application have made rapid advances, but are yet to attain a state of technical maturity that allows their adoption into real-world settings. There remains an 'artificial intelligence chasm' in the spheres of validation, regulation, safe implementation, and demonstration of clinical impact that needs to be bridged before the full potential of artificial intelligence to deliver PHC can be realized. SUMMARY: Ophthalmology is currently in a stage between the demonstration of the potential of artificial intelligence and widespread deployment. Next stages include aggregating and curating datasets, training and validating artificial intelligence systems, establishing the regulatory framework, implementation and adoption with ongoing evaluation and model adjustment, and finally, meaningful human-artificial intelligence interaction with clinically validated tools that have demonstrated measurable impact on patient and healthcare system outcomes. Ophthalmologists should leverage the ability of artificial intelligence systems to glean insights from large volumes of multivariate data, and to interpret artificial intelligence recommendations in a clinical context. In doing so, the field will be well positioned to lead the transformation of health care in a personalized direction. VIDEO ABSTRACT: http://links.lww.com/COOP/A35.


Assuntos
Algoritmos , Inteligência Artificial , Assistência à Saúde/métodos , Oftalmologia/métodos , Medicina de Precisão/métodos , Doenças Retinianas/terapia , Humanos
16.
Graefes Arch Clin Exp Ophthalmol ; 258(11): 2341-2352, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32813110

RESUMO

PURPOSE: Technological advances in recent years have resulted in the development and implementation of various modalities and techniques enabling medical professionals to remotely diagnose and treat numerous medical conditions in diverse medical fields, including ophthalmology. Patients who require prolonged isolation until recovery, such as those who suffer from COVID-19, present multiple therapeutic dilemmas to their caregivers. Therefore, utilizing remote care in the daily workflow would be a valuable tool for the diagnosis and treatment of acute and chronic ocular conditions in this challenging clinical setting. Our aim is to review the latest technological and methodical advances in teleophthalmology and highlight their implementation in screening and managing various ocular conditions. We present them as well as potential diagnostic and treatment applications in view of the recent SARS-CoV-2 virus outbreak. METHODS: A computerized search from January 2017 up to March 2020 of the online electronic database PubMed was performed, using the following search strings: "telemedicine," "telehealth," and "ophthalmology." More generalized complementary contemporary research data regarding the COVID-19 pandemic was also obtained from the PubMed database. RESULTS: A total of 312 records, including COVID-19-focused studies, were initially identified. After exclusion of non-relevant, non-English, and duplicate studies, a total of 138 records were found eligible. Ninety records were included in the final qualitative analysis. CONCLUSION: Teleophthalmology is an effective screening and management tool for a range of adult and pediatric acute and chronic ocular conditions. It is mostly utilized in screening of retinal conditions such as retinopathy of prematurity, diabetic retinopathy, and age-related macular degeneration; in diagnosing anterior segment condition; and in managing glaucoma. With improvements in image processing, and better integration of the patient's medical record, teleophthalmology should become a more accepted modality, all the more so in circumstances where social distancing is inflicted upon us.


Assuntos
Betacoronavirus , Doenças Transmissíveis Emergentes/epidemiologia , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Oftalmologia/métodos , Pneumonia Viral/epidemiologia , Telemedicina/métodos , Humanos , Oftalmologia/organização & administração , Pandemias , Telemedicina/organização & administração
17.
Curr Opin Ophthalmol ; 31(5): 351-356, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32740068

RESUMO

PURPOSE OF REVIEW: The use of artificial intelligence (AI) in ophthalmology has increased dramatically. However, interpretation of these studies can be a daunting prospect for the ophthalmologist without a background in computer or data science. This review aims to share some practical considerations for interpretation of AI studies in ophthalmology. RECENT FINDINGS: It can be easy to get lost in the technical details of studies involving AI. Nevertheless, it is important for clinicians to remember that the fundamental questions in interpreting these studies remain unchanged - What does this study show, and how does this affect my patients? Being guided by familiar principles like study purpose, impact, validity, and generalizability, these studies become more accessible to the ophthalmologist. Although it may not be necessary for nondomain experts to understand the exact AI technical details, we explain some broad concepts in relation to AI technical architecture and dataset management. SUMMARY: The expansion of AI into healthcare and ophthalmology is here to stay. AI systems have made the transition from bench to bedside, and are already being applied to patient care. In this context, 'AI education' is crucial for ophthalmologists to be confident in interpretation and translation of new developments in this field to their own clinical practice.


Assuntos
Inteligência Artificial , Interpretação Estatística de Dados , Oftalmologistas , Assistência à Saúde , Humanos , Oftalmologia/métodos
18.
Asia Pac J Ophthalmol (Phila) ; 9(4): 285-290, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32657805

RESUMO

Coronavirus disease 19 (COVID-19) was first reported in Wuhan, China, in December 2019, and has since become a global pandemic. Singapore was one of the first countries outside of China to be affected and reported its first case in January 2020. Strategies that were deployed successfully during the 2003 outbreak of severe acute respiratory syndrome have had to evolve to contain this novel coronavirus. Like the rest of the health care services in Singapore, the practice of ophthalmology has also had to adapt to this rapidly changing crisis. This article discusses the measures put in place by the 3 largest ophthalmology centers in Singapore's public sector in response to COVID-19, and the challenges of providing eye care in the face of stringent infection control directives, staff redeployments and "social distancing." The recently imposed "circuit breaker," effectively a partial lockdown of the country, has further limited our work to only the most essential of services. Our staff are also increasingly part of frontline efforts in the screening and care of patients with COVID-19. However, this crisis has also been an opportunity to push ahead with innovative practices and given momentum to the use of teleophthalmology and other digital technologies. Amidst this uncertainty, our centers are already planning for how ophthalmology in Singapore will be practiced in this next stage of the COVID-19 pandemic, and beyond.


Assuntos
Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Oftalmologia/métodos , Pneumonia Viral/epidemiologia , Setor Público , Telemedicina/métodos , Betacoronavirus , Infecções por Coronavirus/transmissão , Humanos , Pandemias , Pneumonia Viral/transmissão , Singapura/epidemiologia
19.
Semin Ophthalmol ; 35(4): 210-215, 2020 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-32644878

RESUMO

Telemedicine is the provision of healthcare-related services from a distance and is poised to move healthcare from the physician's office back into the patient's home. The field of ophthalmology is often at the forefront of technological advances in medicine including telemedicine and the use of artificial intelligence. Multiple studies have demonstrated the reliability of tele-ophthalmology for use in screening and diagnostics and have demonstrated benefits to patients, physicians, as well as payors. There remain obstacles to widespread implementation, but recent legislation and regulation passed due to the devastating COVID-19 pandemic have helped to reduce some of these barriers. This review describes the current status of tele-ophthalmology in the United States including benefits, hurdles, current programs, technology, and developments in artificial intelligence. With ongoing advances patients may benefit from improved detection and earlier treatment of eye diseases, resulting in better care and improved visual outcomes.


Assuntos
Inteligência Artificial , Betacoronavirus , Infecções por Coronavirus/complicações , Oftalmopatias/diagnóstico , Oftalmologia/métodos , Pandemias , Pneumonia Viral/complicações , Telemedicina/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Oftalmopatias/complicações , Humanos , Programas de Rastreamento/métodos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
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