Dr. Keith D. Gordon
Senior Research Officer, Canadian Council of the Blind
The COVID-19 pandemic has brutally exposed those living with vision impairment to even greater stress than the sighted community due to social distancing requirements, impacting their ability to negotiate the outdoors and public spaces. Many of those who need assistance are no longer able to leave their homes, leading to greater solitude, depression, and the potential for further sight loss.
Adequate treatment requires regular care
Two of the major causes of vision loss among older adults, wet age-related macular degeneration (wAMD) and diabetic macular edema (DME), require regular injections into the eye to prevent further vision deterioration. In spite of the dire consequences that may be experienced due to patients missing their injections, clinicians are reporting that up to one third of patients are missing their injection visits.
In April 2020, the Canadian Council of the Blind (CCB) conducted a survey of people living with vision loss across Canada in order to better understand the impact of COVID-19 on their lives. Many respondents said they were concerned that they might lose vision as a result of not being able to see their eye doctor. One respondent commented: “I need injections every four weeks in order to maintain my current visual acuity. If I get sick and am unable to see my doctor… I am afraid my vision will deteriorate. His work of doing injections for [wAMD] is an essential service for me and for many others.”
What’s more, control of vision loss due to wAMD, DME, or glaucoma relies on early diagnosis and treatment of the disease. Early diagnosis is achieved through a complete eye examination by an optometrist or ophthalmologist. It’s therefore particularly concerning that optometrists report that up to 50 percent of their patients missed regular appointments due to the pandemic. This means that many patients will have irreversibly lost vision by the time their disease is diagnosed and treated.
Clinicians are reporting that up to one third of patients are missing their injection visits.
Access in the time of COVID-19
At the same time, both ophthalmologists and optometrists fear that they may become swamped once the pandemic is over and the backlog of patients clamours to receive their eye injections or eye examinations.
A study conducted by the Canadian Medical Association shows a significant decrease in the number of cataract surgeries performed during the pandemic and a corresponding increase in the wait times for surgery. This means that people needing cataract surgery will unnecessarily lose vision while they wait for surgery and may be at risk of some of the deleterious effects of vision loss, such as falls and clinical depression.
To safely bring patients with eye diseases back to the clinic to receive their scheduled sight-saving care, prevent avoidable blindness, and reduce the associated negative impact on those affected, the CCB, together with other members of Retina Action, a global coalition of organizations concerned with vision loss, is calling on governments in Canada and around the world to develop plans that provide additional support for the provision of eye care at this time. Such plans should include additional funding for eye examinations; eye injections or medications for the treatment of wAMD, DME, and glaucoma; and additional cataract surgeries. Furthermore, it’s essential that people living with vision loss be given priority with respect to COVID-19 vaccination to enable them to return to regular eye doctor visits and treatments, and to minimize the isolation and loneliness that those with vision loss are currently experiencing.