Ophthalmologists must be flexible in adapting to changing circumstances - EuroTimes
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Ophthalmologists must be flexible in adapting to changing circumstances


Jesper Hjortdal MD, PhD

With emergency admissions relating to the COVID-19 pandemic under control for the moment, one of Denmark’s larger ophthalmological centres has been able to return to elective surgery ahead of most other European countries.

Jesper Hjortdal MD, PhD, told EuroTimes that the eye department where he works at Aarhus University Hospital, which carries out between 60,000-70,000 outpatient visits and close to 10,000 surgeries annually, has been performing some elective surgeries since last month.

“From March 12, the hospital sector was closed down for our elective patients other than emergency cases, to be able to treat patients with COVID-19. Around 50% of the nurses and 20% of the residents in the eye department have been transferred to the COVID-19 referral centre and intensive care units on the hospital. As the pandemic seemed to have peaked in Denmark around April 1 and as the number of COVID-19 patients needing hospital treatment were much less than expected, we started seeing elective patients and performing elective surgeries such as corneal transplantations and cataracts again from mid-April,” he said.

Strict social distancing rules and rigorous hygiene protocols will continue to be enforced in the weeks and months ahead, said Dr Hjortdal.

“We will have fewer patients in our waiting rooms in order to comply with the distance recommendations. Our outpatient rooms are systematically wiped down with disinfectant on all surfaces where patients have contact. We have a shield between patient and examiner at all slit lamps. We have stopped air-puff tonometry as this may create aerosol-generated contamination and we use iCare or applanation tonometry with single-use heads,” he said.

At the main entrances to the hospital all patients are asked about possible COVID-19 symptoms. Those who respond in the affirmative are tested before admittance. All patients also disinfect hands at the entrance and relatives are not allowed to enter the hospital, unless they are accompanying a child or elderly patient who requires assistance.

Furthermore, all patients undergoing general anaesthesia or tear duct/lacrimal surgery need to be COVID-19 tested at least two days before admittance. All hospitalised patients are tested, whereas patients undergoing ambulatory surgery, which is more than 95% of procedures, are not currently tested, he added.

Dealing with the backlog of patients whose elective surgery was postponed during the initial lockdown phase will be one of the priorities for the months ahead, said Dr Hjortdal.

“Emergency patients, including cases with ocular pain, children with special needs such as risk of amblyopia, have been seen and treated during the lockdown. Cancelled patients with disabling visual problems will be prioritised first. Fortunately, we hope to be able catch up with postponed corneal and ocular surface disease patients over the next months, but may expand clinic hours also to comply with the new distancing rules and to reduce the backlog,” he said.

Dr Hjortdal said that one of the key lessons that he has taken from the COVID-19 pandemic is that it pays to be flexible in adapting to changing circumstances.

“We are part of one the largest hospitals in Northern Europe with all kind of specialties. The hospital has around 10,000 employees and the total activity is close to 1 million outpatient visits per year and close to 100,000 surgeries. In our hospital, we have learned that it is possible to achieve a major turn-around very fast, without compromising patient care significantly,” he concluded.

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