Kerala Journal of Ophthalmology

EDITORIAL
Year
: 2020  |  Volume : 32  |  Issue : 3  |  Page : 219--220

The silent epidemic – Are we neglecting it?


V Sudha 
 Department of Ophthalmology, Government Medical College, Thrissur, Kerala, India

Correspondence Address:
Dr. V Sudha
Department of Ophthalmology, Government Medical College, Thrissur, Kerala
India




How to cite this article:
Sudha V. The silent epidemic – Are we neglecting it?.Kerala J Ophthalmol 2020;32:219-220


How to cite this URL:
Sudha V. The silent epidemic – Are we neglecting it?. Kerala J Ophthalmol [serial online] 2020 [cited 2021 Apr 21 ];32:219-220
Available from: http://www.kjophthal.com/text.asp?2020/32/3/219/304542


Full Text



The COVID pandemic has brought life literally to a halt. Health-care systems have weakened and health-care delivery has been put on the back burner. Elderly men and women who suffer from multiple comorbidities are the most affected as restrictions have been imposed on their movements and lifestyles, including getting fresh air and exercise in lieu of them being most susceptible to the virus. The aftermath of the corona pandemic will be equally problematic with vulnerable populations facing socio-economic disadvantages too.

The psychology of the pandemic and the inability to continue hospital visits has led to a situation where neither the patient nor the medical professional can judge the prognosis of many chronic illnesses like diabetes and cardiovascular disease. We in Ophthalmology face additional problems of continuing to provide care in visually debilitating diseases like glaucoma and cataract, especially in community models like camps. Ongoing care for conditions like diabetic retinopathy and glaucoma is of utmost importance to prevent an explosion of a population affected with severe visual impairment or blindness.

The burden of noncommunicable diseases and noncommunicable eye diseases has been highlighted in this issue by the President of the KSOS. Implementation of The Kerala Model “Vision Rehabilitation Centres” has also been marked as a priority by our Society.

Babu et al. have noted in their study that a significant number of patients could not get adequate treatment during the lockdown period. The number of patients undergoing intravitreal injections, laser treatment for peripheral tears as well as retinal vascular pathologies has dwindled. In the absence of timely intervention, such patients will show progression to advanced stages.[1] Similarly in the same issue, a survey done concluded that the majority of ophthalmologists in India were not seeing patients during the COVID-19 lockdown, with the near-total cessation of elective surgeries[2] and these so-called elective interventions are mostly critical services to preserve or restore vision. Cataract continues to be the major cause of blindness and responsible for 66.2% of blindness in India.[3]

The Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, mentions the target of reducing the prevalence of blindness to 0.3% by the year 2020.[4] Under the recently issued guidelines on safe ophthalmology practices in the COVID-19 scenario, the union health ministry has said the screening of patients for cataract and other eye diseases in outreach areas needs to be undertaken after duly following social distancing, hand hygiene, and personal protective measures.[5] Encouraging remote consultations by nongovernmental organization in vision centers, the union health ministry has said identified patients may be called to the base hospital by appointment for cataract surgery, so that backlog of such cases does not build up.

The novel coronavirus pandemic is not coming to an end anytime soon as fresh waves of infection are occurring globally. Many of these degenerative eye diseases will silently and relentlessly progress to blindness. Urgent changes need to be incorporated in Ophthalmic care at all levels, beginning with talking about these issues in all forums available, including Ophthalmic conferences, government-level meetings, and public discourses. Brainstorming by all concerned stakeholders to resolve these issues must be done at the earliest.

The risk of delaying eye care is too high.

Time is running out…….

References

1Babu N, Kohli P, Mishra C, Sen S, Arthur D, Chhablani D, et al. To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute. Indian J Ophthalmol 2020;68:1540-4.
2Nair AG, Gandhi RA, Natarajan S. Effect of COVID-19 related lockdown on ophthalmic practice and patient care in India: Results of a survey. Indian J Ophthalmol 2020;68:725-30.
3National Blindness and Visual Impairment Survey India 2015-2019- A Summary report Available from: https://npcbvi.gov.in/writeReadData/mainlinkFile/File341.pdf. [Last accessed on 2020 Aug 27].
4National Programme for Control of Blindness and Visual Impairment (NPCB&VI). Available from: https://dghs.gov.in/content/1354_3_National Programme for Control of Blindness Visual.aspx. [Last accessed on 2020 Aug 27].
5Government of India Ministry of Health and Family Welfare. Guidelines on Safe Ophthalmology Practices in COVID-19 Scenario. Government of India Ministry of Health and Family Welfare.; August 19, 2020. Available from: https://www.mohfw.gov.in/pdf/GuidelineforEyeCare.pdf. [Last accessed on 2020 Aug 27].