The ongoing pandemic has led to increased severity and morbidity in eye conditions of people in Bengaluru because of delayed treatment and lifestyle changes due to the pandemic. The elderly people have been particularly impacted, with cases of mature cataracts going up as much as five times compared to the period before the pandemic. Incidence of severe dry eyes has also risen three times as people have been spending more time glued to digital screens.

According to Dr. Ram Mirlay, Regional Head – Clinical Services, Dr. Agarwals Eye Hospital, Bengaluru: “During the last one year of the pandemic, patients have been worried about contracting coronavirus if they visited a hospital. Most people with pre-existing eye problems did not go for regular follow-ups during the lockdown and even afterwards, leading to aggravation of their condition. Others with newly developed eye problems waited to consult the doctors, which led to serious consequences, including loss of vision.

He further added-” In the last three months of 2019, before the pandemic had hit fully, just 10 percent of all cataract patients coming to our hospital were suffering from mature cataract. In the last quarter of 2020, this figure jumped to 50%, a five-fold increase. We have also noticed worsening of existing cases of glaucoma in many patients as they hesitated to come for regular follow-ups. People with diabetes ignored their period eye check-ups, leading to severe complications in their retina. Pandemic has had a huge socio-economic impact too. Many cataract patients coming to us are opting to get operated in only one eye, as they are running low on finances due to reduced income.”

Dr. Archana S, Regional Head – Clinical Services, Dr Agarwals Eye Hospital, Bengaluru says “Cases of severe dry eyes due to digital eye strain jumped from 10% before the pandemic to 30% now, as working from home led to loss of work-life balance and people got habituated to looking at digital screens for long hours. Those working on digital screens blink much less than normal, and even the blinks are not fully complete. This, coupled with glare and flickering of screens, has led to a big spike in incidence of digital eye strain and dry eyes. To give relief to the eyes, the rule is that for every 20 minutes of computer work, you should look away for 20 seconds to objects at least 20 feet away, or, better still, look out of the window.”

Says Dr. Ram Mirlay: “Diabetic patients above 50 years old need to get their eyes screened at least once a year by an ophthalmologist, as over 30% of them go on to develop some form of diabetic eye disease, including vision-threatening diabetic retinopathy. Such patients should be extra careful in the pandemic time and do not hesitate to visit a hospital for regular check-ups. Any delay can create more severe complications, including loss of vision. This is true for Glaucoma patients too. If their condition is unstable or they develop unusual symptoms such as eye pain or changes in vision, they should see the doctor immediately.”

It is important for people to not neglect their eye problems in pandemic times. To begin with, tele-consult is a good option and, in many cases, should be enough to get the right advice. Sometimes the doctor will advise to consult in person. That is the time when not doing anything can aggravate a minor eye problem to a more serious one. Rather than delaying treatment, choose an eye hospital where all safety precautions are being implemented.

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Patients with severe comorbidities were one of the most affected amongs’t the many sections that have been affected by the COVID19 pandemic. They were hit hard by the lockdown imposed across India in April and May unable to move out for treatments, no proper guidance from the doctors, not enough attention was paid towards ill patients as they stayed indoors. They have not only been hit hard by the lockdown but the effects of it were very damaging for them in many other ways. But it was mandatory for the government of India to impose restrictions in the larger interest of the people of the country and we must obey the guidelines with no other alternative option.

Fears of cross-infection of COVID19:

From June onwards the government has started relaxing the restrictions which helped out some serious patients with various illnesses to undergo treatment and take recourse of the doctors and their advice. Still, the majority of the patients whose condition is aggravating further are reluctant to visit the hospitals with the fears of cross-infection of COVID19. This may be true to some extent but in another way, it may be fatal as well. Keeping in view of the fears of the patients majority of hospitals are carrying out diligent infection control practices and protocols in the pandemic in all the hospitals. Take an example of MaxiVision eye hospital which has seen an estimated 50,000 visitors to 14 branch hospitals from 1^st of June till 31^st July out of which 20,000 are patients with various eye problems. No single visitor got a cross-infection of COVID19.

Eye problems may lead to major problems:

There are certain eye problems like glaucoma and diabetic retinopathy which are the cause of irreparable/permanent blindness for many in India if not treated in time. Glaucoma is a group of eye diseases that can cause vision loss and blindness by damaging a nerve in the back of your eye called the optic nerve.  The symptoms will begin slowly that one may not notice them. The only way one can find out if they have glaucoma is to get a comprehensive eye exam done.  There’s no cure for glaucoma, but early treatment can often prevent the damage and protect your vision. Depending upon the severity of the case doctors may advise medicine or laser treatments or Surgery.

As per the reports there are approximately 11.2 million persons aged 40 years and older with glaucoma in India. Primary open-angle glaucoma is estimated to affect 6.48 million persons. The estimated number with primary angle-closure glaucoma is 2.54 million. Those with any form of the primary angle-closure disease could comprise 27.6 million persons. Most of those with the disease are undetected and there exist major challenges in detecting and treating those with the disease.

Another cause of permanent blindness is Diabetic Retinopathy if not treated in time. Diabetic retinopathy is caused by damage to the blood vessels in the tissue at the back of the eye (retina). Not properly controlled or poorly controlled blood sugar is a risk factor. Early symptoms include blurry vision, dark areas of vision, and difficulty recognizing colors. It may lead to blindness . Mild cases may be treated with careful diabetes management. Advanced cases may require laser treatment or surgery. There are millions of patients with diabetic retinopathy in India.

Some DO’S & DON’T’S:

The eye is one of the most important sense organs of the body. It should be seen with the utmost care, delaying the problem with pandemic fears may lead us for permanent blindness. Here are a few tips to protect yourselves from cross-infection of COVID19.

1. Maintaining personal hygiene is the most important precaution one has to take.

2. Wash your hands especially before eating after using the restroom, sneezing, coughing, or blowing your nose.

3. Avoid touching your face particularly your eyes, nose, and mouth.

4. If you wear contact lenses avoid using them during monsoon, as the chances of infection are higher during monsoon.

5. Visit the hospitals which follow diligent infection control practices and protocols in the pandemic in the hospitals.

Also Read: INFECTION CONTROL DURING PANDEMIC IN HOSPITALS

ACUTE CONJUNCTIVITIS – THE ONLY PRESENTING SIGN AND SYMPTOM IN COVID 19 ?

Dr. Kasu Prasad Reddy – Chief Surgeon & Founder
MaxiVision Eye Hospitals, Hyderabad

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