The COVID-19 pandemic and ophthalmic care: a qualitative study of patients with neovascular age-related macular degeneration (nAMD)

ABSTRACT Background/aims Concerns have been expressed about the relationship between reduced levels of health care utilisation and the COVID-19 pandemic. This study aimed to elicit and explore the views of patients with neovascular age-related macular degeneration (nAMD) regarding the COVID-19 pandemic and their ophthalmic care. Methods Between April 29th and September 4th 2020, semi-structured telephone interviews were conducted with thirty-five patients with nAMD taking part in a larger diagnostic accuracy study of home-monitoring tests. Participants were recruited using maximum variation sampling to capture a range of key characteristics including age, gender and time since initial treatment. Transcribed interview data were analysed using a deductive and inductive thematic approach. Results Three themes emerged from the analysis: i. access to eye clinic care. ii. COVID-19 mitigating factors and care delivery and iii. social and personal circumstances. Participants reported anxieties about cancelled or delayed appointments, limited communication from clinic-based services about appointments, and the impact of this on their ongoing care. Despite these concerns, there was apprehension about attending appointments due to infection risk and a perception that nAMD patients are a ‘high risk’ group. Views of those who attended clinics during the study period were, however, positive, with social distancing and infection control measures providing reassurance. Conclusions These findings contribute to our understanding about experiences of patients with nAMD during the COVID-19 pandemic and have potential implications for future planning of care services. Innovative approaches may be required to address issues related to access to care, including concerns about delayed or cancelled appointments. Synopsis Perspectives of patients with neovascular age-related macular degeneration regarding the COVID-19 pandemic identified important issues regarding access to, and experience of ophthalmic care. These findings have implications for future planning of services.