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OPHTHALMOLOGY BUSINESS 112 February 2018 by Vanessa Caceres EyeWorld Contributing Writer Ophthalmologists who have lived through them share stories, lessons learned F rom hurricanes to flooding to earthquakes to wildfires, 2017 had no shortage of natural disasters. As resi- dents around the U.S. and the globe rushed to escape damage, ophthalmologists also participated in the madness and sadness that occurs during natural disasters. Sev- eral ophthalmologists shared their experiences and lessons learned so others can be prepared for future natural disasters. Helping the community During Hurricane Irma in Florida in September 2017, Bascom Palmer Eye Institute, University of Miami, stayed open to serve patients, but it also was a shelter for 300 employees on the emergency team and their families as well as members of the Miami police and Federal Emergen- cy Management personnel. As part of a large university, Bascom Palmer is prepared for hurricanes with deployment plans designed well in advance by the university's disaster planning com- mittee, said Eduardo Alfonso, MD, professor and chairman, Bascom Palmer Eye Institute. Special teams at the university go into action at certain points before a storm and aid with recovery after, leading to a well-orchestrated event, Dr. Alfonso said. "We learned from Andrew," Dr. Alfonso said, referring to the 1992 hurricane in South Florida that in addition to causing more than $20 billion in overall damage, led Bascom Palmer to lose power for a week. The organization did not have storm windows at that time (they are much more common in Florida since Andrew), and the city of Miami had no running water for 3 days. When the water was running again, it was contaminated for sev- eral days and unable to be used by medical facilities, Dr. Alfonso said. Bascom Palmer now has a triple backup power system. Although the hurricane was not as disastrous to South Florida as planned, except for in the Florida Keys, staff on duty treated many trauma-related injuries caused by nails or wood incurred when res- idents boarded up their windows. There were also traumatic eye inju- ries that occurred during post-storm cleanup and injuries from airbags that released during car accidents around the time of the storm, said Ranya Habash, MD, assistant pro- fessor, Bascom Palmer Eye Institute, and consultant for TopLine MD, Miami. One lesser-considered effect of the storm was the loss of reading glasses and medications; as peo- ple prepare for a storm, it's easy for small items to get misplaced. Bascom Palmer staff helped many people replace these items, Dr. Al- fonso said. Other patients in the area who recently had eye surgery and needed follow-up were able to be seen at Bascom Palmer until other area offices reopened. Bascom Palmer communicated via social networks and the Florida Society of Ophthal- mology to let doctors know about this option. Bascom Palmer also has a mobile van that can travel to com- munities (and did so during Irma) to help patients. Dr. Habash praised how staff, including Dr. Alfonso, administra- tive staff, and first-year residents who had never experienced a hurri- cane in Florida stayed behind during the storm to help others. "Patients came through with blinding inju- ries. Our team worked around the clock to help them," she said. Pearls and lessons learned • Use social media to communi- cate. Dr. Alfonso was pleasantly surprised by the effectiveness of social media to spread news among doctors during the storm. There were 120 ophthalmologists in the area linked to WhatsApp, a communication app, and it worked well, he said. • Have a plan B in case your office can't open, either short term or long term. You may not be able to see patients a few days after the storm—but you also need to con- sider if a storm is so devastating that patients will move away, Dr. Alfonso said. Treating storm-related injuries "The National Hurricane Center had predicted that Hurricane Irma would smack us right in Broward County and that we would get pummeled," said Alan Mendelsohn, MD, Eye Surgeons & Consultants, Holly- wood, Florida. As mentioned previ- ously, Hurricane Andrew devastated South Florida in 1992, and forecast- ers said that Irma would be worse. As everyone in the area hun- kered down, Dr. Mendelsohn, a corneal specialist, began to treat patients with foreign bodies in the eye and cornea abrasions caused by injuries from nails and wood as homeowners used plywood to cover windows. On a typical day without Dealing with natural disasters Dr. Alfonso celebrates a child's birthday at Bascom Palmer Eye Institute during Hurricane Irma. Source: Bascom Palmer Eye Institute

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