Early-Phase Perceptions of COVID-19’s Impact on Ophthalmology Practice Patterns: A Survey from the Pan-American Association of Ophthalmology

Francisco Javier Bonilla-Escobar,1– 3,* Daniel Sánchez-Cano,1,* Andres F Lasave,4 Jaime Soria,5 Valentina Franco-Cárdenas,6 Victor E Reviglio,7 Paulo EC Dantas,8 Claudia Palacio Pastrana,9 Juan Carlos Corbera,10 Rita Yee Chan,11 Alberto Luis Diaz,12 Milton Garcia Hernandez,13 Mauricio Maia,14 Cristian Carpentier,15 Lihteh Wu,16 Martin Sanchez,17 Marcelo Murillo Sasamoto,18 Gonzalo Murillo Azcárraga,18 Jose A Roca,19 Martin A Serrano,20 Arturo A Alezzandrini,21 Juan Gonzalo Sanchez Montoya,22 Gregorio Gabela,23 Gerardo Garcia-Aguirre,24 J Fernando Arevalo25,* 1Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia; 2Ophthalmology Department, Institute for Clinical Research Education, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; 3Vision y Salud Ocular, VISOC, Ophthalmology Department, Universidad del Valle, Cali, Colombia; 4The Retina and Vitreous Department, Private Eyes Clinic, Mar del Plata, Argentina; 5Ophthalmology Department, Clínica Real Visión, Uniofken, CIVE y Funcrisa, Guayaquil, Ecuador; 6Ophthalmology Department, Sanatorio Oftalmológico Mérida, Mexico City, Mexico; 7Ophthalmology Department, Instituto de la Visión Cerro, Sanatorio Allende Cerro & Universidad Católica de Córdoba, Health Science Faculty, Cordoba, Argentina; 8Ophthalmology Department, Sorocaba Eye Bank Hospital, Sorocaba, Brazil; 9Department of Microsurgery of the Anterior Segment, Fundación Hospital Nuestra Señora de la Luz IAP, Mexico City, Mexico; 10Ophthalmology Department, Oftalmica Clinica de la Vision, Lima, Peru; 11Ophthalmology Department, Clinica Nacional de Oftalmologia, Panama City, Panama; 12Ophthalmology Department, Complejo Medico FOSCAL Internacional, Floridablanca, Santander, Colombia; 13Ophthalmology Department, Private Practice, El Salvador, El Salvador; 14Ophthalmology Department, Federal University of Sao Paulo, Sao Paulo, Brazil; 15Ophthalmology Department, Fundación Oftalmológica Los Andes, Santiago, Chile; 16Retina Department, Asociados de Macula Vitreo y Retina de Costa Rica, San Jose, Costa Rica; 17Ophthalmology Department, Hospital de Minas, Montevideo, Uruguay; 18Ophthalmology Department, Instituto Privado de Oftalmología, La Paz, Bolivia; 19Ophthalmology Department, Universidad Peruana Cayetano Heredia, Lima, Peru; 20Retina Department, Centro Médico Docente La Trinidad, Caracas, Venezuela; 21Ophthalmology Department, OFTALMOS, Universidad de Buenos Aires, Facultad de Medicina, Buenos Aires, Argentina; 22Ophthalmology Department, Instituto Nacional de Investigacion en Oftalmologia –INIO and Clinica Oftalmologica de Antioquia, Medellin, Colombia; 23Ophthalmology Department, Hospital Metropolitano, Quito, Ecuador; 24Retina Department, School of Medicine, Tecnológico de Monterrey Asociación Para Evitar la Ceguera en México, Mexico City, Mexico; 25Ophthalmology Department, Johns Hopkins University, Wilmer Eye Institute, Baltimore, MD, USA*These authors contributed equally to this workCorrespondence: J Fernando Arevalo, Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Maumenee 713, Baltimore, MD, 21287, USA, Email arevalojf@jhmi.eduPurpose: The COVID-19 pandemic affected medical practice worldwide due to interventions to prevent spreading. Its effect on ophthalmology practices in Latin America has not yet been explored. We aimed to assess the perceptions about the pandemic from countries’ ophthalmological national and subspecialty retina societies affiliated to the Pan-American Association of Ophthalmology (PAAO).Patients and Methods: A survey-based study of leaders of national ophthalmological and retinal societies was conducted. The survey was sent by email to 30 societies, from which 20 responded (12 countries, 66.6% response rate). It included closed- and open-ended questions about (1) operational capacity and precautions, (2) telemedicine and virtual care, (3) procedures, and (4) post-pandemic considerations.Results: There was a marked decline in ophthalmology patient visits (80– 95%) and elective surgeries (90%) during 2020 compared to before the pandemic. Precautions like temperature checks, mask usage, and social distancing were widely implemented while personal protective equipment (PPE) availability varied. Telemedicine use was limited due to lack of experience with it. Reopening plans focused on maintaining precautions and gradually resuming activities. Economic and security concerns were raised, and adherence to guidelines was emphasized. Respondents acknowledged the need to adapt to a “new normal”. Long duration drugs, fewer imaging studies, and shorter wait times were preferred; however, availability of long duration drugs was limited.Conclusion: The pandemic impacted ophthalmology in Latin America, with reduced patient visits, procedures, and surgeries. Delayed treatment and complications were likely the result of the pandemic.Keywords: COVID-19, pandemics, international agencies, ophthalmology, retina, medical societie