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1.
Isr Med Assoc J ; 23(2): 76-81, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33595210

RESUMO

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic presented a major medical management challenge to ophthalmology departments throughout Israel. OBJECTIVES: To examine the managerial challenges, actions taken, and insights of directors of ophthalmology departments in Israel during the COVID-19 pandemic. METHODS: We conducted a cross sectional survey of directors of ophthalmology departments during the COVID-19 pandemic while the Israeli population was quarantined. RESULTS: All 21 directors answered the survey. The majority of the COVID-19 admissions were located in the center of Israel (53%) and Jerusalem (30%). E-communication took a central role in coping with the pandemic with 80% of the directors satisfied with this form of communication; 75% reported a reduction in clinical and surgery volume of at least 25%, and 40% reported reallocations of manpower. Most of the medical staff used gloves, a face shield, disposable robe, and a mask with no uniformity across departments. Cross satisfaction was noted regarding a hospital's ability to equip the departments. Lack of preparation for post-pandemic era was reported by all directors, but one (95%). Directors sought guidelines and uniformity regarding outpatient referral to the hospital (p = 0.035). CONCLUSIONS: Guidelines via safe digital platforms aid in management decisions and uniformity across departments. Advanced preparation is needed to prevent adverse clinical outcomes and to maintain treatment continuum. Our results can be used to guide and help improve the preparedness of ophthalmology departments during COVID-19 and for future pandemics.


Assuntos
Departamentos Hospitalares/organização & administração , Oftalmologia/organização & administração , Equipamento de Proteção Individual/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Adulto , Comunicação , Estudos Transversais , Equipamentos Descartáveis/estatística & dados numéricos , Luvas Protetoras/estatística & dados numéricos , Departamentos Hospitalares/normas , Humanos , Israel , Máscaras/estatística & dados numéricos , Pessoa de Meia-Idade , Equipamento de Proteção Individual/provisão & distribução , Quarentena , Encaminhamento e Consulta , Inquéritos e Questionários
2.
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
6.
Curr Opin Ophthalmol ; 31(5): 396-402, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32740066

RESUMO

PURPOSE OF REVIEW: To discuss key considerations involved in adapting an in-person ophthalmology conference to a virtual medium. RECENT FINDINGS: In 2020, several ophthalmological societies have held or are planning to hold virtual conferences in lieu of their previously scheduled in-person ophthalmology conference because of the coronavirus disease 2019 pandemic. The strategic meeting components attempted to be retained in these transitions include educational information disseminating, academic discussion with colleagues, sponsorships, and networking. Live-streamed components of a virtual conference may be entirely real time or may include a combination of both prerecorded and live-streamed components. A virtual meeting may offer either a single live-streamed program or several concurrent live-streamed programs from which attendees can choose. The availability of on-demand content, mechanisms for audience participation, avenues for industry interaction and contribution, registration costs, and continuing medical education credit availability vary between virtual meeting formats. SUMMARY: Transition of an in-person ophthalmology conference to a virtual format with retention of the inherent value associated with the meeting is possible and the experiences of societies executing this adaptation can be helpful for others entering this space. There are numerous considerations regarding meeting format and logistics to contemplate in light of each meeting's specific audience and objectives.


Assuntos
Betacoronavirus , Congressos como Assunto/organização & administração , Infecções por Coronavirus/epidemiologia , Oftalmologia/organização & administração , Pneumonia Viral/epidemiologia , Comunicação por Videoconferência , Humanos , Pandemias , Comunicação por Videoconferência/organização & administração
8.
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
11.
Curr Opin Ophthalmol ; 31(5): 366-373, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32694270

RESUMO

PURPOSE OF REVIEW: The aim of this article is to assess the current state of teleophthalmology given the sudden surge in telemedicine demand in response to the novel coronavirus 2019 (COVID-19). RECENT FINDINGS: Recommendations and policies from government and national health organizations, combined with social distancing, have led to exponential increases in telemedicine use. Teleophthalmology can be integrated into ophthalmic care delivery. In the emergency room, teleophthalmology can be utilized to triage patients and diagnose common ophthalmic eye diseases. Ophthalmology practices can utilize real-time medicine to conduct many parts of an in-person exam. In cases where more complex diagnostic tools are warranted, a model incorporating telemedicine and focused in-person visits may still be beneficial. Innovative technologies emerging in the market allow for increased remote monitoring, screening, and management of adult and pediatric patients for common eye diseases. SUMMARY: COVID-19 created a demand for healthcare delivery that limits in-person examination and potential viral exposure. Teleophthalmology allows ophthalmologists to continue caring for patients while keeping physicians and patients safe. Although challenges still exist, the pandemic has accelerated the adoption of teleophthalmology. As a result, teleophthalmology will play an integral role in providing high-quality efficient care in the near future.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Assistência à Saúde , Oftalmologia/métodos , Pneumonia Viral/epidemiologia , Telemedicina/métodos , Oftalmopatias/diagnóstico , Humanos , Oftalmologia/organização & administração , Pandemias , Telemedicina/organização & administração
12.
Ocul Immunol Inflamm ; 28(5): 709-713, 2020 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-32721206

RESUMO

This document summarizes the experience of the International Uveitis Study Group (IUSG), the Intraocular Inflammation Society (IOIS), and the Foster Ocular Inflammation Society (FOIS) and can aid as a guide for the treatment of uveitis patients in the era of COVID-19 pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Oftalmologia/organização & administração , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto/normas , Padrões de Prática Médica/normas , Uveíte/diagnóstico , Uveíte/terapia , Consenso , Infecções por Coronavirus/diagnóstico , Humanos , Internacionalidade , Pandemias , Pneumonia Viral/diagnóstico , Fatores de Risco , Sociedades Médicas
13.
PLoS One ; 15(7): e0235699, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645065

RESUMO

Despite significant evidence around barriers hindering timely access to cataract surgery in low- and middle-income countries (LMICs), little is known about the strategies necessary to overcome them and the factors associated with improved access. Despite significant evidence that certain groups, women for example, experience disproportionate difficulties in access, little is known about how to improve the situation for them. Two reviews were conducted recently: Ramke et al., 2018 reported experimental and quasi-experimental evaluations of interventions to improve access of cataract surgical services, and Mercer et al., 2019 investigated interventions to improve gender equity. The aim of this systematic review was to collate, appraise and synthesise evidence from studies on factors associated with uptake of cataract surgery and strategies to improve the uptake in LMICs. We performed a literature search of five electronic databases, google scholar and a detailed reference review. The review identified several strategies that have been suggested to improve uptake of cataract surgery including surgical awareness campaigns; use of successfully operated persons as champions; removal of patient direct and indirect costs; regular community outreach; and ensuring high quality surgeries. Our findings provide the basis for the development of a targeted combination of interventions to improve access and ensure interventions which address barriers are included in planning cataract surgical services. Future research should seek to examine the effectiveness of these strategies and identify other relevant factors associated with intervention effects.


Assuntos
Extração de Catarata , Acesso aos Serviços de Saúde , Oftalmologia/organização & administração , Extração de Catarata/economia , Extração de Catarata/estatística & dados numéricos , Países em Desenvolvimento , Feminino , Humanos , Gestão da Saúde da População , Pobreza , Sexismo
15.
Indian J Ophthalmol ; 68(8): 1540-1544, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32709770

RESUMO

Purpose: To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute. Methods: Records of all the patients who presented from March 25th to May 3rd, 2020 were scanned to evaluate the details regarding the presenting complaints, diagnosis, advised treatment and surgical interventions. Results: The number of outpatient department visits, retinal laser procedures, intravitreal injections and cataract surgeries during this lockdown decreased by 96.5%, 96.5%, 98.7% and 99.7% respectively compared from the corresponding time last year. Around 38.8% patients could be triaged as non-emergency cases based on history alone while 59.5% patients could be triaged as non-emergency cases after examination. Only eighty-four patients opted for video-consultation from April 15th to May 3rd, 2020. Nine patients presented with perforated corneal ulcer, but could not undergo penetrating keratoplasty due to the lack to available donor corneal tissue. One of these patients had to undergo evisceration due to disease progression. Two patients with open globe injury presented late after trauma and had to undergo enucleation. Around 9% patients could not undergo the advised urgent procedure due to logistical issues related to the lockdown. Conclusion: A significant number of patients could not get adequate treatment during the lockdown period. Hospitals need to build capacity to cater to the expected patient surge post-COVID-19-era, especially those requiring immediate in-person attention. A large number of patients can be classified as non-emergency cases. These patients need to be encouraged to follow-up via video-consultation to carve adequate in-person time for the high-risk patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Oftalmopatias/terapia , Oftalmologia/estatística & dados numéricos , Pandemias , Assistência ao Paciente/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Quarentena , Academias e Institutos/organização & administração , Academias e Institutos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Hospitais Especializados/organização & administração , Hospitais Especializados/estatística & dados numéricos , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Oftalmologia/organização & administração , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos
18.
J Fr Ophtalmol ; 43(7): 577-585, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32564983

RESUMO

This prospective observational cohort study is based on the first 500 patients who requested emergency teleconsultation during the initial days of the COVID-19 lockdown in Paris, France between 20 March and 10 April 2020. It is the first study to assess the utility of emergency teleophthalmology with a simple smartphone application or web browser and a webcam to manage emergency eye care in a population with sudden restricted access to ophthalmologists. In this study, every patient who asked for an ophthalmic emergency consultation in a single specialized center in Paris ('SOS Œil') first had to undergo a teleconsultation appointment to evaluate the indication for a physical consultation to preserve lockdown. Under medical advice only, a physical appointment was given within a day (if necessary). The aim of the study was to describe the population and diagnoses and evaluate the main judgment criteria, defined as the 'ability of teleconsultation to properly indicate a physical consultation for fair diagnosis and treatment in eye emergencies'. This organization has permitted physicians and patients to preserve social distancing while avoiding 3 or 4 physical consultations per person. Notably, 27% of teleconsultations were followed by a physical appointment. There was a mean 4.12-day delay between symptom apparition and consultation, and less than 1 day for traumas, superficial corneal foreign body and neuro-ophthalmological emergencies. There was a 96% sensitivity and 95% specificity to properly evaluate the indication of a physical consultation and only 1.0% misdiagnoses that lead to delayed care. Hence, teleconsultation maintained satisfactory healthcare access to patients with severe ophthalmological disorders while preserving social distancing and sanitary precautions. Therefore, teleconsultation may be seriously considered as a way to efficiently regulate ophthalmic emergencies, especially for patients with limited access to a specialist.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Oftalmologia/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Quarentena , Telemedicina/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Agendamento de Consultas , Criança , Pré-Escolar , Erros de Diagnóstico , Emergências/epidemiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Oftalmologia/organização & administração , Pandemias , Paris/epidemiologia , Estudos Prospectivos , Sensibilidade e Especificidade , Distribuição por Sexo , Telemedicina/métodos , Adulto Jovem
20.
Eur J Ophthalmol ; 30(4): 621-628, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32418481

RESUMO

INTRODUCTION: The novel coronavirus (SARS-CoV-2) is infecting people and spreading easily from person-to-person. Cases have been detected in most countries worldwide. Italy is one of the most affected countries as of 30 March 2020. Public health response includes a rapid reorganization of the Italian National Healthcare System in order to reduce transmission of COVID-19 within hospitals and healthcare facilities, while optimizing the assistance to patients with severe COVID-19 complications. METHODS: We analysed the actions that were taken in three ophthalmology centres in northern Italy during the SARS-CoV-2 outbreak and how these measures affected patient's attendance. In addition, due to the rapidly evolving scenario, we reviewed the evidence available during the course of this pandemic. RESULTS: A full reorganization of ophthalmology services is mandatory according to current existing infection containment measures in order to continue dispensing urgent procedures without endangering the community with amplification of the diffusion chain. Ophthalmologists are considered at elevated risk of exposure when caring patients and vice versa, due to their close proximity during eye examination. High volumes of procedures typically generated by ophthalmologists with concurrent implications on the risk of infection are considered when re-assessing healthcare facilities reorganization. CONCLUSION: Containment measures in the event of pandemic due to infective agents should be well known by healthcare professionals and promptly applied in order to mitigate the risk of nosocomial transmission and outbreak.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Oftalmologia/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecção Hospitalar/transmissão , Oftalmopatias/diagnóstico , Oftalmopatias/terapia , Humanos , Controle de Infecções/organização & administração , Itália/epidemiologia , Oftalmologia/normas , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Triagem/organização & administração
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