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The challenge of quality eyecare post-COVID

Inescapable issues must be addressed by every healthcare practitioner

Dermot McGrath

Posted: Friday, February 19, 2021

The thorny question of maintaining quality eyecare in the face of dwindling resources and increased demand from ageing populations will provide the timely focus of the symposium “Too Many Patients, Too Few Doctors, Better Eyecare”, which will be held on the opening day of the 25th ESCRS Winter Meeting Virtual 2021.

“These are issues which are inescapable and which need to be addressed by every healthcare practitioner sooner rather than later,” says Prof David Spalton, who is co-chairing the symposium with Prof Jorge Alió.

“We have been aware for years that the population is getting older and eye disease is more common in the elderly, which equates to more glaucoma, more cataracts, more retinal disease. In addition, we are faced with a static or dwindling number of medical and nursing personnel and restrained budgets for medical care. And of course, the COVID-19 pandemic has heightened and expedited a problem which has been building for years,” says Prof Spalton.

Opening the symposium, Prof Rudy Nuijts will present data from a study carried out by his team at Maastricht University Hospital in the Netherlands looking at the possible benefits of immediate sequential bilateral cataract surgery (ISBCS).

“I think ISBCS it will constitute the majority of cataract surgery cases in five years’ time,” says Prof Spalton. “It has advantages for the patient because it gets everything done in one go, and there are benefits for the hospital in terms of workflow and more efficient financial use of resources. It remains controversial because of the perceived risk of bilateral complications. However, we now have solid data showing that the outcome is just as good as unilateral surgery once strict protocols are adhered to,” he says.

In the next presentation, Iain Livingstone MD will highlight the immense potential of telemedicine to serve dispersed populations in rural areas, reduce crowded clinics and avoid unnecessary hospital visits for patients. Dr Livingstone will discuss his experience setting up a pioneering virtual emergency teleophthalmology programme covering a large part of Scotland in response to the COVID-19 emergency. The network uses inexpensive equipment and a live video feed to securely connect doctors, opticians and patients and ensure that patients with serious eye problems can be immediately diagnosed and treated.

The symposium will be rounded off by Nick Strouthidis, Medical Director of Moorfields Eye Hospital in London, who will focus on the possibilities of training paramedical support to meet the challenges of delivering safe and effective eyecare. He cited the example of Moorfields paramedical intravitreal injection programme, which has seen a dedicated team of nurses delivering injections for AMD patients and laser capsulotomies with no compromise on patient safety.

“They have shown that well-trained nurses can safely administer injections, and may in fact get less complications than a junior doctor who has not performed many injections,” notes Prof Spalton. “While these ideas are controversial to some, it is vitally important we provoke debate and to get people thinking about how we are going to manage our patients in the future with more pressure on time and resources,” he says.

Too Many Patients, Too Few Doctors, Better Eyecare Friday 19 February | 17.00 – 19.00. See here.