Retrospective analysis of ophthalmology referrals to a tertiary academic centre during the COVID-19 pandemic in comparison to the pre-COVID-19 era

Schlenker, Amanda; Tadrous, Carol; Ching, Geoffrey; Iovieno, Alfonso; Nathoo, Nawaaz; Liu, Tom; Yeung, Sonia N.

OBJECTIVE: This study was conducted to analyze emergency ophthalmology referrals to a Canadian tertiary academic centre during the current coronavirus disease 2019 (COVID-19) pandemic in comparison to pre-pandemic referrals. DESIGN: This was a retrospective chart review looking at emergency referrals seen by the ophthalmology service between March 18 to April 17, 2020 (representing the COVID-19 period) and March 18 to April 17, 2019 (representing the pre-COVID-19 period). METHODS: Data gathered from referral records included patient demographics, timing and site of referral, and ophthalmic diagnosis. Referrals were categorized as urgent or non-urgent, with urgent indicating the need for ophthalmic assessment within 24 hours. RESULTS: The total number of referrals decreased by 54.2% in the COVID-19 period versus the pre-COVID-19 period. There was a similar bimodal age distribution in both periods, with fewer patients over 65 years of age presenting during the pandemic. Tertiary hospital referrals decreased by 62% in the pandemic period, while non-tertiary emergency department referral trends varied and outpatient clinic referrals increased by 16%. Overall, there was a significant shift in the distribution of referral sites (p=0.04). The proportion of urgent referrals increased by 14% during the pandemic; this was not statistically significant. There was no significant change in the timing of referrals nor in the distribution of diagnostic segments. CONCLUSIONS: This study offers insight into the impact of the COVID-19 pandemic on ophthalmology referral patterns in a Canadian context. Moving forward, it helps to guide resource allocation and public education on the importance of seeking necessary eye care.