Impact of Covid 19 pandemic on pattern of paediatric inpatient referral for ophthalmic consultation in a teaching institute hospital

Abstract

Importance:Pediatric inpatient referral for Ophthalmology consultations are often requested to evaluate a variety of conditions at a teaching institute hospital. The on-going coronavirus disease (COVID-19) pandemic has affected every aspect of health care in general, including inpatient referrals that could result in long term adverse effect due to the delay in screening, management and providing of required care. Objective: To know the change in paediatric inpatient referral pattern for ophthalmic consultation from pre COVID to COVID times and the effect of the same on visual morbidity. Design, Setting, and Participants: This retrospective record review study included paediatric inpatient references for ophthalmology consultation in a teaching institute hospital from Dec 2019 to May 2020. Result: Of the total 67 inpatient referrals requested, 45 were during preCOVID-19 times (group 1) and 22 during COVID-19 pandemic (group 2). Mean age was 4.85 ±4.47 and 4.55 ± 4.35 years in group 1 and 2 respectively. Refractive error was the cause for referral in 10 patients in group 1 and none in group 2(P=0.019). Referral for optic disc oedema assessment was seen in 6 and 15 in group 1 and 2 respectively (P=0.000). 2 and 4 patients were referred in group 1 and 2 respectively to screen for cataract (P=0.069) of which a group 1 patient was diagnosed and treated for the same. While 10 and 2 patients were referred for ophthalmic screening (P=0.193), it was 3 and 1 for strabismus (P=0.732) respectively in group 1 and 2. Conclusion: COVID times adversely affected the inpatient refractive error screening, a cause of amblyopia in older patients. In patient referral for papilledema screening increased despite the pandemic as the condition is considered an emergency.