Impact of Covid 19 pandemic on pattern of paediatric inpatient referral for ophthalmic consultation in a teaching institute hospital

Abstract

Importance: Paediatric inpatient referral for Ophthalmology consultations are often requested to evaluate a variety of conditions at a teaching institute hospital. The on-going corona virus disease (COVID-19) pandemic has affected every aspect of health care in general, including inpatient referrals that could result in long term adverse effect due to the delay in screening, management and providing of required care. Objective: To know the change in paediatric inpatient referral pattern for ophthalmic consultation from pre COVID to COVID period and the effect of the same on visual morbidity. Design, Setting, and Participants: This retrospective record review study included paediatric inpatient references for ophthalmology consultation in a teaching institute hospital from Dec 2019 to May 2020. Patient profile, date of admission, diagnosis, reason for referral and ophthalmic evaluation details were collected from medical record charts. Data obtained was tabulated and analysed. Result: Total of 67 inpatient referrals were requested. Group 1 (45 patients, 67.17%) were during pre COVID period and group 2 (22 patients, 33.83%) included patients in the pandemic period. Mean age was 4.85±4.47 and 4.45±4.35 years in group 1 and group 2 respectively. Refractive error (P=0.019) and ophthalmic screening was the cause for referral in majority in group 1. Referral for optic disc oedema screening was the cause in majority in group 2(P=0.000) Conclusion: COVID period adversely affected the inpatient refractive error screening, a cause of amblyopia in older patients. Inpatient referral for papilledema screening increased despite the pandemic as the condition is considered an emergency.