Eyeworld

MARCH 2021 | EYEWORLD | 103 G social distancing. Surgeries for patients who test positive for COVID are either postponed or, if urgent, performed in a dedicated OR, typically at the end of the day to allow for terminal disin- fection. Surgeons and staff wear N95 respirators in the OR. Early months of the pandemic Dr. Salim said that her practice remained open to provide in-person services to urgent and emergent patients. "We also started using tele- health platforms for routine patients to ensure continuity of care," she said. "Other than providing ophthalmic care, we were deployed to a COVID testing center where hundreds of patients were screened daily for the virus. We were extremely fortunate to have ade- quate PPE for all physicians, nurses, and staff at the testing center," she added. "It was gratifying to serve the community and demonstrate our collective resolve and strength during these difficult times." NYEE also remained open, though Dr. Vinod noted modifications to all aspects of daily operations. "Our hospital is a major hub for ophthalmic care not only for the five boroughs of New York City but also the tri-state area and beyond," she said. "As such, we remained open even at the height of the pandemic to provide urgent and emergent glaucoma care when routine visits and elective surgery were being postponed throughout the region." Brian Francis, MD, said that his practice only saw emergent cases when the pandemic began. Regular checks were postponed, but the practice still saw those with high pressures or those who were unstable. His practice did not transition to drive-thru IOP checks. Dr. Francis said this did not work logistically, but he noted that there was an effort to make visits quick and socially distanced. Telemedicine At the height of the pandemic, Dr. Vinod em- braced teleophthalmology as a way to deliver routine glaucoma care. "Telemedicine visits for glaucoma have proven useful in my practice for reviewing medications and their instructions for use, assessing adherence to and adverse effects from eye drops, and counseling patients about their diagnosis and management plans." However, Dr. Vinod noted that glaucoma management relies heavily on in-person diag- nostic evaluation/testing. Although some tools are available for remote monitoring, most are still in early stages of development or haven't been adequately validated. Dr. Singh finds the "hybrid" telemedicine appointments particularly useful. During the early stages of the pandemic, he said his prac- tice relied heavily on telemedicine, but even with a return to office-based practice, he still finds it a useful tool for triaging patients. With this model, patients see technicians for in-per- son diagnostic tests, then Dr. Singh follows up later on a call to discuss. "Patients love having the time online to do telemedicine," he said. "They think it's more intimate with the doctor not being in the office." He added that his practice will continue continued on page 104 Each slit lamp biomicroscope at NYEE is equipped with a large plastic breath shield, which serves as a barrier between the examiner and patient. Source: Kateki Vinod, MD

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