Francesco Carones MD
On March 11 2020, the World Health Organisation characterised COVID-19 as a pandemic.
Two days later on March 13, the Director-General of WHO, Dr Tedros Adhanom Ghebreyesus announced that 5,000 people had lost their lives to COVID-19.
“This,” said Dr Ghebreyesus, “is a tragic milestone. Europe has now become the epicentre of the pandemic, with more reported cases and deaths than the rest of the world combined, apart from China,” he said.
Italy was, and remains to be, at the epicentre of the pandemic with more than 201,500 cases of the virus reported up to the end of April.
But after months of suffering, there may be a light at the end of the tunnel.
In the middle of April, Dr Francesco Carones, reopened his private practice CARONES Vision in Milan for elective surgeries.
“My practice has always been open for urgencies and emergencies, both clinical and surgical. We started back doing some elective procedures,” said Dr Carones. “We are doing seven-to-eight procedures per week, of which one to two are emergencies.”
Italy is emerging slowly from the COVID-19 lockdown measures and Dr Carones acknowledges that it will take time for his clinic to match his number of pre-COVID procedures.
“For cataract surgery, I think we will be back to pre-COVID numbers in a month or so, because most of the surgeries are covered by private insurance. For refractive procedures it will take longer, let’s say, September,” he told EuroTimes.
Like other ophthalmologists, Dr Carones has had to make substantial changes in his practice working closely with Managing Director of CARONESVision, Amanda Cardwell Carones.
“We integrated video consultations for routine follow-ups as well as preoperative patient education,” said Dr Carones. “We have also implemented a home visit programme conducted by one of our young ophthalmologists for patients who are unable or unwilling to leave their homes, which includes autorefractometry and visual testing, slit-lamp examination of the anterior and posterior segment, evaluation of the tear film and tonometry.”
One of the biggest challenges facing ophthalmologists since the outbreak of COVID-19 is the introduction of new safety measures for patients and staff to help prevent the spread of the virus.
Strict precautions are being implemented to screen patients for COVID-19 before they are allowed to attend a visit, including triaging by phone when they book their appointment.
“This is repeated at the clinic on the day of their visit. Patients are provided ‘wellness kits’ upon arrival that include shoe covers, non-impermeable gowns, surgical masks and hair covers,” said Dr Carones. “We check temperature via an infrared thermal camera, and for surgical patients we conduct antibody tests.”
“All the staff wear Personal Protective Equipment (PPE) – shoe covers, surgical gown, N-95 FFP2 mask, gloves, screen shields or goggles and hair covers. Patients wear shoe covers, non-impermeable overalls, surgical masks and hair covers,” said Dr Carones.
The need for physical distancing is also very important and CARONESVision is also limiting the number of patients attending the clinic, with no persons accompanying patients unless necessary and no access to the clinic earlier than 10 minutes before the appointment time.
Another challenge that will face ophthalmologists and other health professionals post-COVID is the need to restructure the physical space in which they operate.
“We are fortunate that we had just moved in a much larger practice before the outbreak of the pandemic, so we have plenty of space,” said Dr Carones. “The practice was designed to minimise contact and interaction between people, so no structural changes were necessary. We have fitted our desks with transparent insulating shields and slit lamps with protective shields.”
Surgical hygiene is also very important.
“We already moved to single-use surgical instruments and diagnostic tools like examination lenses,” said Dr Carones. “As for the diagnostic instruments and all surfaces in the diagnostic and visiting area, we are sanitising them after each use with 70% alcohol disinfectants.
Amanda Cardwell Carones stressed that the future success of CARONESVision will continue to be based on the dedication and hard work of all the staff who work at the clinic.
“These have been very rough weeks and months, but we are hopeful and confident that we can look forward to a bright future in the ever-changing post-COVID environment,” she said.
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