Facial Plast Surg 2022; 38(02): 219-220
DOI: 10.1055/s-0041-1731347
Letter to the Editor

Alterations in Oculoplastics Practice Patterns during COVID-19: A Call for Preparedness

1   Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
2   City University of New York School of Medicine, New York, New York
,
Victoria S. North
1   Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
,
Ann Q. Tran
1   Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
,
Arpita Maniar
1   Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
,
Michael Kazim
1   Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
› Author Affiliations

The coronavirus disease 2019 (COVID-19) pandemic led to unprecedented challenges in all medical specialties. In March 2020, the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) recommended cessation of all nonemergent oculofacial care. To our knowledge, the impact of COVID-19 on the overall practice of oculoplastic surgery has not been formally evaluated. To understand the effects of the pandemic on oculoplastics practice patterns, the authors distributed a survey to ASOPRS members. With our findings, we urge oculofacial practitioners to consider formulating emergency response plans tailored to their practice setting to prevent the recurrence of similar pitfalls.

An invitation to participate in a 12-question, anonymous, web-based survey was distributed via email to all ASOPRS members. Informed consent was obtained from each participant via the online link. This study was approved by Institutional Review Board.

The overall survey response rate was 19% (177/958). Nearly half of survey respondents (42%) reported that their patient volume decreased by 75%. An additional 33% perceived a 50% volume reduction. After cessation of lockdown regulations, only one-third of participants (32%) felt that their surgical volume returned to prepandemic levels, while a slightly larger number (36%) reported that their surgical volume had decreased by 25%. Functional conditions (34%), malignancies (19%), and infections (10%) were the most commonly encountered problems. A total of 28% of respondents found the pathology more severe in presentation, particularly regarding malignancies and orbital disease. Regarding management strategies, 28% of participants reported they were less likely to recommend immunosuppressive treatment (i.e., corticosteroids). Nasolacrimal procedures posed a unique challenge during the pandemic due to the theoretical risk of aerosolizing COVID-19 viral particles. Delayed dacryocystorhinostomy was reported by 34%. Altered surgical practices such as choice of lacrimal stent and postoperative management including delayed stent removal were noted in 10%. Nearly half of participants (46%) reported that their patients had limited access to digital platforms. Other common challenges to healthcare access at this time included inadequate transportation (44%) and language barriers due to suboptimal translational services (6%). Certain clinical conditions including ectropion and entropion (66%), dermatochalasis (61%), and ptosis (53%) were viewed as most suitable to completely address via telehealth consultations.

Awareness of variations in management tendencies during the COVID-19 pandemic can aid oculofacial practitioners in drafting plans for practice preparedness in the event of a future disaster. Our study additionally underscores various socioeconomic barriers that were likely exacerbated by the pandemic—a topic that warrants discussion beyond the scope of this letter. Telehealth, while evidently useful in many settings, continues to face barriers to adequate use. Our study is limited by the relatively low response rate and inherent risk of recall bias. Further investigations are needed to describe additional ways in which the pandemic altered oculofacial practice. The authors ultimately urge physicians to tailor emergency response plans based on the trends seen in the oculofacial community. Ultimately, understanding developments in practice management during the pandemic will improve the quality and delivery of patient care in the future.



Publication History

Article published online:
12 June 2022

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