ABSTRACT
Purpose : To examine how the quantity and characteristics of ophthalmology consults at a New York City hospital system changed during the COVID-19 pandemic peak. Methods : In an IRB approved, HIPAA compliant retrospective, comparative chart review study, ophthalmology (initial, follow-up, and electronic) consult notes from February to May 2019 were compared to those in February to May 2020. Statistical comparisons between 2019 and 2020 were made using T-tests and Fisher's exact tests. Results : Of 2,215 notes analyzed, 1,374 (62%) were from 2019 and 841 (38%) were from 2020 (p=0.0002). Baseline characteristics between groups, including chronic medical conditions, did not differ significantly. In 2019, 41% of patients had a primary hospital diagnosis related to ophthalmology, whereas in 2020 this decreased to 32% (p=0.002). In 2019, 7.5% of patients were on ventilators;this increased in 2020 to 10.8% (p=0.035). Top reasons for consult requests were stable between years: eye pain/pressure (16.4%, 14.1%, p=0.79), trauma (13.1%, 13.7%, p=1), and blurry vision (12.9%, 11.2%, p=0.85) (Figure 1). After evaluation, the most common diagnoses in 2019 were trauma (14.0%) and glaucoma (10.9%). In 2020, they were trauma (15.2%) and retinopathy of prematurity (11.2%). In 2020, 1.8% of consults were in a newly available format, the e-consult (telephone visit). Within 2020, the number of consults decreased at the end of February (-47.5 %) and in mid-March (-44.1%) (Figure 2). In 2020, 22.5% of all consults were COVID tested and 2.4% of all consults were positive within 2 weeks of in-person evaluation. Conclusions : These results reflect changes in the activity of the ophthalmology consult service during the peak of the COVID-19 crisis. Consult quantities decreased dramatically in late February and mid-March, which correlate with the timing of the first COVID-19 case in New York State (reported February 29) and the New York State on Pause Program that required all non-essential workers to stay home (ordered March 22). The lower number of ophthalmology consult requests in 2020 may reflect that patients with non-acute eye problems did not seek medical attention and/or primary teams deferred requests.