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LETTER TO EDITOR
Year : 2020  |  Volume : 8  |  Issue : 2  |  Page : 83-84

Patient's response and tele-medicine applications under local coronavirus disease-2019 outbreak


Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, HKSAR, China

Date of Submission29-Feb-2020
Date of Decision09-Mar-2020
Date of Acceptance25-May-2020
Date of Web Publication2-Jul-2020

Correspondence Address:
Sunny Chi Lik Au
9/F, MO Office, Lo Ka Chow Memorial Ophthalmic Centre, Tung Wah Eastern Hospital, 19 Eastern Hospital Road, Causeway Bay, Hong Kong, HKSAR
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcor.jcor_17_20

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How to cite this article:
Au SC. Patient's response and tele-medicine applications under local coronavirus disease-2019 outbreak. J Clin Ophthalmol Res 2020;8:83-4

How to cite this URL:
Au SC. Patient's response and tele-medicine applications under local coronavirus disease-2019 outbreak. J Clin Ophthalmol Res [serial online] 2020 [cited 2020 Nov 29];8:83-4. Available from: https://www.jcor.in/text.asp?2020/8/2/83/288841



Dear Editor,

With the increasing number of reported coronavirus disease-2019 (COVID-19) cases worldwide, more is known for the virus.[1] Some authorities announced possible transmission through direct contact over the conjunctiva mucosa;[2] thus, ophthalmology clinic patients theoretically are of particular risk of infection, given the numerous amount of topical anesthetic and mydriatic eye drops usage across different patients in the clinic.

Here, we present our data on patient's response as nonattendance to ophthalmology clinic follow-up under the local COVID-19 respiratory disease outbreak in our city [Chart 1]. Our regional public hospital was equipped with all subspecialties including respiratory medicine, emergency department, and intensive care units and pressure-controlled isolation rooms, thus receiving referrals for suspected COVID-19 cases. Our city got the first confirmed case of COVID-19 on January 23, 2020,[3] hospitalized in another regional hospital over the harbor, and that day was defined as day 0 in our investigative period. Despite handling many suspected cases, our hospital did not have any confirmed cases throughout the investigative period. The first local mortality case appeared on day 4/5; patients' home-to-hospital traveling time by public transportation was calculated on the official government webpages at http://hketransport.gov.hk with their registered residential addresses.



A total of 3596 patients were scheduled for follow-up during the investigative period (from day 5 to 11), and the daily nonattendance rate is shown in Chart 1. There was significant increment on nonattendance on day 0 and 5 after, respectively, the first locally confirmed and mortality case. By analyzing the 726 patients who defaulted the ophthalmology clinic follow-up from day 0 to 11, retinal diseases contributed the majority of 39% [Chart 2]. Besides, essential follow-ups for refilling of glaucoma medications (12%) and eye infection cases (9%) also contributed significantly. Their mean traveling time to hospital was 30.1 (range 5–65) min only.



The surge in nonattendance partially reflected patients' fear upon traveling in public area and clustering within the hospital.[4] The situation was worrisome, and tele-ophthalmology tools used to be applied in rural area were found exceptionally useful for the continuation of patients' care,[5] despite within a concrete jungle like Hong Kong. Synchronous tele-consultation via phone was basics, yet difficulties were encountered with tele-monitoring and tele-interpretation even under store-and-forward format.[6] Major obstacle fell on the patients' data acquisition due to unavailability of examination equipment on their hands. Application of three-dimensional (3D) printing filled this gap,[7] such as smartphone adapters for fundus photograph taking, which might be helpful despite different technical limitations. This would be useful for triaging patients' urgency toward onsite ophthalmological interventions.

In conclusion, tele-ophthalmology and 3D printing play an essential role under COVID-19 outbreak when accessibility to healthcare service challenged many patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Lu CW, Liu XF, Jia ZF. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet 2020;395:e39.  Back to cited text no. 1
    
2.
Li JO, Lam DS, Chen Y, Ting DS. Novel coronavirus disease 2019 (COVID-19): The importance of recognising possible early ocular manifestation and using protective eyewear. Br J Ophthalmol 2020;104:297-8.  Back to cited text no. 2
    
3.
Au SCL. Revisiting the Role of Telemedicine Under the 2019 Novel Coronavirus Outbreak. Eur J Geriatr Gerontol 2020;2:26-27.  Back to cited text no. 3
    
4.
Au SCL. A surge in eye clinic nonattendance under 2019 novel coronavirus outbreak. Indian J Ophthalmol 2020;68(5):948.  Back to cited text no. 4
    
5.
Mohammadpour M, Heidari Z, Mirghorbani M, Hashemi H. Smartphones, tele-ophthalmology, and VISION 2020. Int J Ophthalmol 2017;10:1909-18.  Back to cited text no. 5
    
6.
Wilson LS, Maeder AJ. Recent directions in telemedicine: Review of trends in research and practice. Healthc Inform Res 2015;21:213-22.  Back to cited text no. 6
    
7.
Akkara JD, Kuriakose A. The magic of three-dimensional printing in ophthalmology. Kerala J Ophthalmol 2018;30:209-15,  Back to cited text no. 7
    




 

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