Update on current guidelines for Outpatient and Surgeries in the era of COVID Crisis

 Update on current guidelines for Outpatient and Surgeries in the era of COVID Crisis

Nadisha P Singh

London, UK

Abstract:

Statement of the problem: In the era of Covid-19, evidence-based approach is being promoted as the go-to means for risk mitigation and patient safety. We have to accept that medicine has a lot of catching up to do, given the novelty and rapid spread of this particular virus. Major and meaningful clinical trials need a certain amount of time before they can produce reliable results. Meanwhile, smaller pilot studies have come forward to offer advice and support.

Methodology and Theoretical Orientation: Covid-19 virus itself is known to affect the eyes causing conjunctivitis and external eye disease. Treatment of systemic Covid-19 with Hydroxychloroquine and Chloroquine (currently abandoned as per WHO) has known to affect the retina causing toxicity based on dosage and duration. Such patients need to be monitored closely. Remdesivir and other antiviral medications can also affect the eyes.

Findings: There are evolving guidelines which have been put forward regarding the treatment for eye conditions in the Covid era for safety of patient and staff. Guidelines regarding use of Personal protective equipment (PPE) and resumption of Ophthalmology services post lockdown are being followed. Since ophthalmology surgery is classified as an aerosol generating procedure, surgical pathways have been formulated to provide eyecare to those in need. There are also specific guidelines for providing urgent eye treatment to Covid/ Covid suspect patients. “Forward triage” is a technique to manage surges in healthcare demand.

Conclusion and significance: Although these guidelines have been formulated and released, they are being updated very regularly based on the ever-changing nature of the pandemic. It is very important that correct evidence-based approach is used while formulating the guidelines. Here, we discuss the current updates on available guidelines pertaining to Ophthalmology in the Covid era.

Recent Publications:

1. Singh, Nadisha P et al. “Lamellar keratoplasty techniques.” Indian journal of ophthalmology vol. 66,9 (2018): 1239-1250. doi:10.4103/ijo.IJO_95_18
2. Singh, Nadisha P et al. “Keratitis in Reactive arthritis: Case series and review of literature.” All India Ophthalmological Society (2017)
3. Singh, Nadisha P et al. “Indications and Technique of ICL exchange.” All India Ophthalmological Society (2017)
4. Singh, Nadisha P et al.” Clinical Outcomes of primary Corneal Tear Repair in tertiary eyecare centre in Western India.” Maharashtra Ophthalmic Society (2016)
5. Singh, Nadisha P et al. “Triangular flap v/s Rectangular flap in Trabeculectomy- A Prospective analysis of Intraocular pressure control and bleb morphology in Primary Glaucoma patients.” National Board of Examinations (2015)
6. Singh, Nadisha P et al. “Primary Osteoarthritis of the knee in Perimenopausal Women: Analysis of Causative factors.” Indian Council of Medical Research (2010)

Biography:

Nadisha Singh is currently working as a Consultant Ophthalmologist in London, UK. She specialises in complicated Cataract surgeries and retinal lasers. She completed her Cataract fellowship from Moorfields eye hospital, London and her basic ophthalmology training in India. She has medical registration to practice in two countries including India and UK and done four fellowships. She has been invited as International faculty in All India Ophthalmology Conference twice. She has also been teaching faculty in various regional courses in UK. She is a member of Royal College of Ophthalmologists, European Society of Cataract and Refractive Surgeons, United Kingdom and Ireland Society of Cataract and Refractive Surgeons, All India Ophthalmological Society, Delhi Ophthalmological Society, Cornea Society of India, International Council of Ophthalmology.