Impact of Lockdown During COVID-19 Outbreak on Ophthalmological Emergency in a Reference Center in France

Purpose: In March 2020, the sudden rise in number of SARS-CoV2 infections in France let the government to impose a strict lockdown during which all non-urgent medical consultations were postponed. From March 17 to May 10, 2020, private medical practices were closed and telemedicine was encouraged. The consequences on ophthalmic care were dramatic with over 90% of scheduled consultations canceled. The aim of this study was to report the consultation during the 2-month strict lockdown in Paris and to analyze its impact on the visual outcomes of patients consulting in the ophthalmology emergency department (OED) Methods :Data of patients who presented to the OED of the A. de Rothschild Foundation Hospital (RFH), a tertiary ophthalmology center in Paris, France, during the lockdown period and its immediate aftermath were analyzed. The results were compared to the same time periods in the years of 2018 and 2019. Four time periods were defined and numbered chronologically: March 17 to May 10, 2018 (Period 1) ; March 17 to May 10, 2019 (Period 2); March 17 to May 10, 2020 (Period 3, the lockdown period); May 11 to June 9, 2020 (Period 4, the post-lockdown period)Results :The number of consultation was reduced by more than 50% during the lockdown period (n=2909 patients) and by 30% during the post-lockdown period (n=2622) when compared to periods 1 (n=7125) and 2 (n=8058) Even though LP4 saw an increase in the number of consulting patients, there was no raise in the rate of severe diseases (12.8% during LP3 vs 11.1% during LP4) and the proportion of patients who were padmitted was statistically similar (4.3% VS 3.6%). Neuro-ophthalmic -diseases were the most common during LP3 and LP4. Neovascular glaucoma were twice as common during post LP4 (p=0.08). We highlighted a significant increase in patients with a graft reject consulting in our OED during the post LP4 (p<0.001). Those results were likely related to a delay in the follow-up consultations due to the lockdown measures.ConclusionThe reduction in the number of consultations in our OED during the lockdown period did not focus mainly on minor emergencies and also affected severe ophthalmic diseases with no significant delay in consultation. More longitudinal and longer study is needed to confirm this and to analyze retrospectively the COVID-19 outbreak and lockdown effects.