Prof Ewa Mrukwa-Kominek
With Poland currently introducing a phased relaxation of the lockdown restrictions put in place to tackle the COVID-19 epidemic, the country’s ophthalmologists are preparing for a challenging and vastly transformed work environment in the weeks and months ahead.
For Prof Ewa Mrukwa-Kominek, Head of the Department of Ophthalmology, Silesian University of Medicine, Katowice, Poland, the pandemic has already forced radical changes in the way that ophthalmology services are organised.
“The current epidemiological situation has caused changes in the functioning of healthcare in our university hospital. All elective surgical operations such as cataract have been deferred until a later date, while urgent procedures such as glaucoma, retinal detachments, and anti-VEGF injections have been continued. Patients who have undergone corneal transplant surgery and severe keratitis come to the ophthalmology outpatient clinic as normal, but with the necessary security measures in place,” she said.
Prof Mrukwa-Kominek believes that telephone triage and telemedicine have important roles to play in filtering patients and ensuring that urgent cases are not neglected.
“Telemedicine allows us to interview the patient, determine the urgency of the follow-up visit, and possibly postpone the visit to a later date. Most ophthalmological inspections are now carried out in the form of a telephone consultation with a doctor, and prescriptions for necessary ocular medicines can be prescribed by an online platform. My own private practice is currently closed in line with the recommendations of the health authorities, so I provide telephone consultations for my patients,” she said.
The current crisis will also force a necessary rethink about the way patients are received and examined after the immediate pandemic has subsided, believes Prof Mrukwa-Kominek.
“For everyday work in an ophthalmic office we will definitely use additional covers and special shields for slit lamps, and personal protective equipment for staff with protective glasses, gowns and specialised masks. The organisation of patient waiting rooms and queues for the doctor’s office will also be transformed to ensure enhanced security and without direct contact between patients,” she said.
Dealing with the backlog of patients whose examinations or operations were postponed during the pandemic will also require a major organisational effort in the coming months, said Prof Mrukwa-Kominek.
“After returning to normal clinic work, it will be necessary to schedule new appointments for patients who missed visits during the pandemic. We will give priority to urgent cases and those who require closer care such as those who have had corneal transplant surgery. To compensate for the backlog, it may be necessary to extend our consultation times and see as many patients as possible,” she said.
The confinement measures are also having an impact on the training of young ophthalmologists, points out Prof Mrukwa-Kominek.
“We are a university hospital and we have been continuing training as much as possible through e-learning. However, the first online exam in ophthalmology for our 450 students will be a challenge if the restrictions do not disappear by the end of June,” she said.
In terms of lessons learned from the COVID-19 crisis, Prof Mrukwa-Kominek said that it is vital to not take things for granted and to be prepared to adapt to changing circumstances.
“The lesson we can learn from the current situation is the knowledge that one should always be prepared for a sudden, unprecedented situation that will force us to reorganise our work,” she concluded.
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