Eye doctor visits are bouncing back from COVID-19 setbacks
Things are finally getting back to normal at eye doctors’ offices across the country.
Visually, “normal” looks very different now. Patients and professionals who had only worn face masks a few times prior to 2020 now loop them around their ears every time they leave their homes. Face shields, which might have been associated with surgeons or scientists before, are now seen on supermarket shoppers.
But strictly by the numbers, the average eye care location is actually getting closer to their pre-COVID “normal.”
The number of patients scheduling routine eye exams and other eye-related appointments continues to recover since the start of the COVID-19 pandemic. Patients are adapting to the safety measures that eye doctors have put into place — measures that have almost become second nature by now.
Patients return to eye care offices
In the early days of the COVID-19 pandemic, comprehensive eye exams took a backseat to government restrictions and an underlying sense of concern.
Nonprofit group The Vision Council estimated that 16 million adult eye exams were lost in the first half of 2020 as a result of the emerging pandemic.
By October, about seven months after COVID-19 first shut down the country, twice as many people felt comfortable enough to schedule an in-person eye exam, according to a Vision Council study.
Participants had the following responses when they were asked about a scheduled eye exam or medical appointment with an eye doctor.
April, 2020 – 51% of people said they would either postpone or cancel their appointment. Only 17% of people said they would keep their originally scheduled time slot.
October, 2020 – Only 26% of respondents said they would cancel or postpone their visit. At this point, 42% of people now said they would keep their originally scheduled appointment.
“After about six weeks, we were able to slowly increase our volume. By August, we were back to about 85% of our normal patient load. Today, we are closer to 95%,” said Dr. Stephanie Lozano, an optometrist and practice administrator at Diagnostic Eye Center in Houston, Texas.
“Our patients have reported that they feel comfortable with the measures we’re taking,” Lozano said.
More recurring appointments are staying on schedule
Dr. Juanita Collier is a behavioral optometrist in Cromwell, Connecticut. She and her staff at 4D Vision Gym specialize in developing and rehabilitating vision for people whose eyesight has been affected by physical or neurological conditions.
The pandemic impacted the timing of her patients’ recurring appointments, which are an important part of many forms of rehabilitation. Most patients were normally seen one to three times every week, Collier said.
“During the COVID shutdown last March, our weekly volume decreased to about 20% of our normal patient load,” Collier said. “[The shutdown] interrupted care for many patients who were in the middle of their therapeutic courses, just as their brains were beginning to lay down new neurological pathways.”
Some of her patients could continue virtually; for most, remote care wasn’t an option.
Now, as COVID-19 precautions become part of daily life, Collier is seeing more patients in the office.
“We have implemented a number of enhanced safety measures that have allowed us to safely reintroduce the most beneficial elements of this patient interaction and now we are continuing to steadily increase our patient load,” Collier said.
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Medical and surgical appointments are also on the rise
Ophthalmologists — medical eye doctors who perform surgeries and tend to manage more complex eye diseases — are also seeing their patients return.
Dr. Joseph Fishkin is an ophthalmologist who operates a private practice in Emerson, New Jersey. Procedures such as cataract surgery and laser vision correction are commonplace at his practice.
Like most in the medical field, Fishkin felt the impact of COVID-19 right away.
“When COVID hit, my patient load dropped to about 30% of my usual numbers,” Fishkin said. “I started my practice 11 years ago, and it was the quietest time in my office in over 10 years.”
But as time went on and people adapted to life during a pandemic, Fishkin saw patients making appointments again.
“I’m fortunate in that my patient volumes bounced back quickly once people felt more comfortable leaving their homes,” Fishkin said. “I'm back to 100% of my normal patient volume.”
Financial side effects
While the pandemic has been financially devastating for many, others have maintained a steady stream of income. Some people are essential workers, while others work for companies (or own businesses) that have been able to weather the economic storm.
In some cases, people who haven’t lost income or are retired now find themselves with a more open schedule and additional savings, since entertainment spending is limited during the pandemic.
This is especially true for many cataract surgery candidates, Dr. Lozano said.
“Many patients see this as a great time for surgery, as they have no travel plans and can more easily recover at home,” Lozano said. “Patients in this demographic also report having more disposable income, as they are unable to vacation.”
“I predict we will continue to see growth in cataract surgery volume over the coming months, as many elderly patients who were hesitant to have surgery are now becoming vaccinated and feeling more comfortable,” Lozano said.
Keeping up with screenings during a pandemic
Optometrists and ophthalmologists are often the first step in the diagnosis of eye-related conditions. Some conditions are mild, but others — like glaucoma and cataracts — can rob people of their vision if they’re left untreated.
With patients coming back to exam chairs, eye doctors can get patients the testing and treatment they need to care for their eyesight. But doctors are still uneasy about the amount of people who haven’t been screened lately.
“We do have concerns that not all of our patients have returned for routine screening,” said Dr. Rocio Pasion, a clinical optometrist at two Siepser Eyecare locations outside of Philadelphia, Pennsylvania. “Glaucoma and age-related macular degeneration develop over time and can be treated more effectively if caught early.”
Siepser has been reaching out to its social media followers to promote the importance of vision screenings and assure them that staff is taking the precautions needed to protect them from viral spread, Pasion said.
Following up remotely
As people get accustomed to life during a pandemic, they’re also getting more comfortable with remote telehealth options.
In April 2020, 6% of respondents said they would utilize a virtual vision screening or checkup instead of an in-person exam, according to a Vision Council survey. By October, interest had increased to 10%.
App- or browser-based vision screenings can be helpful in a pinch, but an online eye exam can’t replace an in-person appointment. As time goes on, though, increasing interest in online appointments could be the elbow-nudge companies need to develop safer, more robust technology for remote visits.
Siepser Eyecare is using phone and video conferences as a way to follow up with patients, review treatment and answer questions after their in-office visit.
“Patients seem to really like it,” Pasion said. “I am not sure if this will become a widespread trend, but it will be something that we continue to embrace in our practice.”
More patients, same safety measures
The number of appointments may be getting closer to pre-COVID levels, but protective measures against viral spread are still an important part of each optical location.
“We are still taking full, maximum precaution at our clinic,” said Dr. Majid “Amir” Moarefi, an ophthalmologist at Eye Physicians of Long Beach in Long Beach, California.
“There's still a large subset of patients who are worried about the contraction of COVID. However, with our measures, we have yet to have anyone contract [COVID-19] from our practice at this time, thankfully,” Moarefi said.
Eye doctors like Dr. Moarefi are using several methods to improve the safety of each eye exam. Across the country, these measures might include:
Face masks worn by staff
Face shields and other forms of PPE worn by staff
Requiring face masks for patients and customers
Limiting the number of people inside the building
Limiting the number of people accompanying patients
Temperature checks before entry
Equipment and furniture sanitization after every patient
Shields on slit lamps and other instruments
Improved air filtration throughout the office
Sanitizing sample eyeglass frames after each try-on
Dr. Fishkin, who also had plexiglass barriers installed at the front desk and performs COVID-19 tests on all surgery candidates, believes this will be the norm well into the future.
“We implemented the same measures most practices put into place. Doing exams with masks and gloves has become routine,” Fishkin said. “I expect it will remain so for a long time to come.”
Vaccines slowly offer another layer of protection
On Siepser Eyecare’s website, a rusty red banner grabs visitors’ attention at the top of the page. It reads, “COVID-19 Protocols in Place. Effective 1/31/2021 all employees are COVID vaccinated.”
Similar notices on office websites nationwide come with sure sighs of relief from patients overdue for an exam.
Groups like the American Optometric Association (AOA) are advocating for eye doctors and staff to be included in the first vaccination group, one that includes people in other health fields, but not always optometry.
Ultimately, the decision of how to categorize eye doctors comes down to the individual states.
“Given the immediate severity of the health worker shortage, the nation’s COVID-19 vaccination response must fully recognize doctors of optometry in the first round of vaccines to ensure Americans a continuity of urgent and emergent eye care, thereby freeing up burdened emergency departments,” AOA president Dr. William T. Reynolds said in a statement.
With each passing week, more eye doctors and staff around the country get their COVID-19 shots.
It’s an important — and possibly final — step toward safeguarding people on the giving and receiving sides of eye care.
Page published on Tuesday, February 16, 2021