ABSTRACT
The effects of COVID-19 on the eye are still widely unknown. We describe a case of a patient who was intubated and proned in the intensive care unit (ICU) for COVID-19 and developed unilateral anisocoria. CT venogram excluded a cavernous sinus thrombosis. MRI of the head showed microhaemorrhages in the midbrain where the pupil reflex nuclei are located. After the patient was stepped down from ICU, intraocular pressure (IOP) was found to be raised in that eye. A diagnosis of subacute closed angle glaucoma was made. It is important for clinicians to rule out thrombotic causes in patients who develop acute anisocoria. It is also crucial to measure IOP in patients who develop ophthalmic pathology and have been proned for extended periods.
Subject(s)
COVID-19 , Glaucoma, Angle-Closure , Anisocoria/diagnosis , Anisocoria/etiology , Glaucoma, Angle-Closure/diagnosis , Humans , Intraocular Pressure , Pupil , SARS-CoV-2ABSTRACT
Appropriate dissemination of information to the general public is a key component of the pandemic response. In 2018, recorded infection control advice messages were affixed to 30% of England's automated hospital switchboards during the seasonal influenza and norovirus outbreaks. As the majority of messages were mandatory for all callers, healthcare professionals using the hospital switchboard - including during time-critical emergencies - had their enquiries significantly delayed by these measures. Importantly, published analyses did not demonstrate an association between these messages and patient outcomes. As of May 2020, 85% of NHS trusts made use of infection control messages; on average, these delayed healthcare professionals by 59.4 seconds per call, but had no clear association with patient outcomes from COVID-19. An ongoing national switchboard quality improvement project seeks to establish a gold standard whereby healthcare professionals with urgent enquiries can press 'X' to skip past infection control messages and have their calls triaged immediately.