ABSTRACT
Purpose : The COVID-19 pandemic led to changes in glaucoma care to ensure patient and provider safety. In this qualitative interview study, we aimed to identify changes perceived as improvements in care that have persisted, even following vaccine rollout and uptrending patient volumes after the pandemic's initial surges. Methods : From July-December 2021, 20 of 45 (44%) NYC glaucoma specialists contacted were interviewed through semi-structured interviews, utilizing a 15 question guide while allowing for exploration of new topics. Interviews were audio-recorded, transcribed, and thematically analyzed with NVivo qualitative software. Results : Thematic saturation was reached after 15 transcripts. Participants included 12 women and 8 men from 9 institutions, in practice for 6-41 years. When asked to rate the change their practice experienced during the pandemic's first surge on a scale of 1 to 5 (5 being the most change), physicians reported a 4.26 ± 0.94. Certain changes have persisted [Figure 1]. Almost all physicians reported that infection prevention protocols (e.g. hand washing, mask donning) remain and may persist after the pandemic subsides. 9 [45%] reported that increasing the follow-up window for stable patients (e.g. from every 4 months to 6 months) was also a persistent change. While practices initially switched to disposable tools (e.g. tonometer tips, gonioscopy lenses), 9 of 17 [53%] physicians who reported on disposable tools have continued their usage. While disposable tool usage has declined since the first wave [p value=0.003;Figure 2], physicians who continued their usage shared positive views on safety and efficiency. 8 [47%] discontinued their usage, reporting negative sentiments around inaccuracy and waste. Telemedicine was not a persistent change, with only 1 provider continuing to use telemedicine. Reported rationale for discontinuation was the inability to collect data such as intraocular pressure, visual field testing and ophthalmoscopy. Conclusions : COVID-19 continues to impact glaucoma care. Persistent practice changes include infection prevention, extended follow-up windows and disposable tool usage, while telemedicine has largely been discontinued. As glaucoma care continues to evolve, these changes have lasting implications for continuity of care, patient safety and care delivery.