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Presentation of infectious keratitis to ED during COVID-19 lockdown

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First Author: B.Power IRELAND

Co Author(s):    A. William Power   -.                  

Abstract Details

Purpose:

To compare presentation of suspected infectious keratitis during COVID-19 lockdown with previous years. To assess relative severity and outcomes between COVID and pre-COVID era groups.

Setting:

Data was collected from the Royal Victoria Eye and Ear Hospital and the Mater Misericordiae University Hospital, both Dublin, Ireland.

Methods:

Acute presentations of suspected infectious keratitis during a strict government mandated COVID lockdown period were analysed (March-May 2020). Data was compared with the same periods in 2018-2019. The clinical notes of patients undergoing corneal scrapes were reviewed and data collected on initial treatment, culture growth, surgical interventions, visual outcomes, admission rates, and risk factor profiles.

Results:

There were 37% fewer presentations of suspected infectious keratitis to the ED in 2020 compared with the same time period in 2018 and 2019. Risk factor profiles and microbial data were similar across all time periods. Admission rates and use of fortified antibiotics were lower in 2020, but COVID-era cases were more likely to require surgical intervention and trended towards inferior visual outcomes.

Conclusions:

A concerning fall in presentations of infectious keratitis to ED during the pandemic lockdown was observed. Though societal behaviour changed during this period, it is unlikely that the incidence of infectious keratitis fell significantly. There was some indication that outcomes may have been inferior. We postulate that patients may have delayed before seeking care and deviations from standard practice in treatment and admission may have lead to inferior outcomes. To minimise avoidable ocular morbidity as COVID resurges, it is important that we communicate clearly with patients and health professionals on how to access available emergency eye care services.

Financial Disclosure:

... gains financially from competing product or procedure, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... is employed by a competing company, ... has significant investment interest in a company producing, developing or supplying product or procedure presented