This is my first blog post this calendar year. (I have been somewhat distracted!) Ironically, for Eye Care Professionals like myself, we had hoped that the year 2020 would have been a big year for the promotion of eye health. Our thunder has most definitely been stolen by the coronavirus pandemic. What is worse, we find ourselves in a situation we never could have imagined, where we are having to cancel non-urgent eye care appointments and surgery, with no definite end-date in sight.
The situation is nothing short of frightening. I am frightened to go in to work every morning, both for fear of potentially spreading the virus to colleagues and patients (many of whom are in high risk groups), and for fear of bringing the virus back home to my family. I am frightened that by cancelling routine appointments, some of my patients will permanently lose sight. I am frightened for my colleagues and friends in A&E and ITU, who are really working on the front line. And I am frightened of being taken out of my comfort zone and being asked to help out on the front line, whilst preparing to do so if that is what is required of me. The predicament is extraordinary, for all wrong reasons!
Regardless, this is where we find ourselves, and we must do with the situation the best we can. I have written this post with the intention of providing a few tips on how to look after your eyes whilst the world has gone on hold. I will keep it as brief as possible, given the huge information overload that everyone is currently experiencing.
If you have a known eye condition, continue your medication unless advised otherwise. For instance, patients with glaucoma should not stop their pressure drops, whilst patients with recent corneal transplants should not stop their steroid drops. If you are having difficulty getting hold of treatment or you are unsure whether or not to continue, call your Eye Care Provider for clarification.
If you have a recurrent eye condition and you develop a flare up of symptoms which you recognise, do not hesitate to contact your local eye department by phone. Whilst we are minimising visits to the hospital, we are still here! It is surprising how much information an experienced Eye Care Professional can get from talking to you over the phone. It may even be possible to get some treatment started without a visit to the hospital, if it is thought to be safe to do so. (Patients known to me can find contact details here.)
If you develop a new eye problem which seems urgent, such as severe eye pain, loss of vision, sudden double vision or a turn in the eye, urgent attention may be required to treat sight-, or rarely life-threatening disease. Although the prospect of coming into hospital at the moment is very scary, many modifications have been made to minimise the risk for the few individuals whose eye condition shouldn’t wait the several months it will inevitably take for this pandemic to settle. Our crowded waiting rooms are now mostly empty, hygiene and disinfection have been vamped up from our already very high standards, and all staff now wear protective equipment including surgical scrubs, gloves, aprons and face masks in all clinical areas. Arrangements will vary depending on where in the country or world you live, so follow the local routes for accessing eye care, but please don’t suffer in silence.
Conjunctivitis (a red, sticky eye with discharge) can develop in a minority of people with COVID-19, although it is thought to be a late feature. In short, if you have conjunctivitis caused by coronavirus, you will most likely already have had the other more common symptoms of the condition such as fever, a new persistent cough and so on. The vast majority of cases of conjunctivitis are self-limiting (they will settle down on their own), particularly if they are caused by a viral infection. Over-the-counter antibiotic eyedrops are all that would normally be recommended by the Eye Clinic, and it is usually safe to try to manage conjunctivitis at home in the first instance. It is not advisable to attend the hospital specifically because of conjunctivitis if you are displaying other potential symptoms of coronavirus. Symptoms which might suggest an eye problem more serious than conjunctivitis include significant eye pain, sensitivity to light, blurred vision and a lack of thick discharge from the eye.
Some recent studies have shown that coronavirus is not usually found in the tears of people with COVID-19 who have no eye symptoms (although larger studies are needed). The virus has, however, been found in tear samples taken from COVID-19 patients with conjunctivitis. It is also important to understand that if the virus comes in contact with the tears/eyes of someone who has never been exposed to it, they may then acquire the infection. This is why the advice you will have heard so many times already about regular hand-washing for 20 seconds, and avoiding touching the face and eyes is so important. If you must touch the eyes, for instance to apply eye drops or insert contact lenses, wash your hands thoroughly with soap and water both before and after you do so.
I said I would try to keep it brief. I have failed, so I will stop here. Please stay home, stay safe, and follow the guidance given by your local health authorities to protect yourselves and others.