As society continues to open up, the Optometry in Practice editorial board thought it opportune to reflect on the experiences of the pandemic to date and assess the impact on both eyecare professionals and our patients.
We all had changes imposed on us over the pandemic, in both our professional and our personal lives. Lockdown brought a sudden change to everyday lives, but it will take time for individuals and organisations to adapt and transition to a new norm.
Gathering, analysing and critically appraising the evidence are all key to shaping the future. We are delighted to share with you the latest peer-reviewed content, themed around ‘COVID-19: One year on’, for this special edition of Optometry in Practice. This special issue delves into the multitude of ways in which the pandemic has profoundly impacted optometrists and eyecare across a broad range of geographical locations, clinical settings and work modalities.
Where better to start than a literature review to help us keep up to date with the growing evidence base? An astonishing approximately 2000 publications mentioning COVID-19 and the eye have been published since December 2019. In our first paper, Professor Shahina Pardhan and researcher Megan Vaughan carried out a review of 137 of these publications relevant to the optometrist in their paper ‘COVID-19 and its impact on eyecare: a review’. Their extensive review describes the potential route of transmission of the SARS-CoV-2 virus via the ocular surface and how optometrists can reduce transmission, and outlines the prevalence, type and timing of ocular signs and symptoms. The impact on the ocular surface of new habits such as mask-wearing and prolonged screen time is also discussed. Evidence is presented on the impact of the COVID-19 pandemic on patients and eyecare delivery.
Change impacts people and processes. To minimise the spread of COVID-19 during the pandemic optometric practices restructured their service provision to provide a safe eyecare environment for their patients. We are pleased to include two papers in this special issue reporting on surveys of eyecare professionals during the pandemic. In our second paper, by Peter M Allen et al., a team from Anglia Ruskin University summarise a survey carried out on practising members of the College of Optometrists to investigate the impact of these changes. Challenges identified included how to ensure safe working practices, continue to provide a comprehensive service and navigate the financial implications. The benefits of new patient pathways, streamlined services, increased skill acquisition and improved professional relationships are all discussed. As the authors point out, the pandemic certainly has been a catalyst to improve some aspects of eyecare. Our third paper, ‘Italian contact lens practitioners’ perspective on providing and adapting contact lens practice during the COVID-19 pandemic’, by Fabrizio Zeri et al., reports on results from a survey of contact lens practitioners in Italy and discusses ways in which contact lens practice has adapted to the pandemic.
Of course, some changes imposed by lockdown will not be welcomed back: remember the unruly hair and the home haircuts? However, many changes have been and should be welcomed. The pandemic has bought an acceleration of innovation, leading to permanent positive shifts, which may help shape the future for the better.
One innovation that is growing in the field of eyecare is the use of digital technology to allow for home monitoring of eye conditions. This type of innovation has potential benefits far beyond the pandemic, such as the freeing up of clinic capacity, closer monitoring to identify those patients in need of revised management strategies and reducing some of the burden of hospital visits for patients.
Our next paper, ‘The use of technology in the home monitoring of eye conditions’, by Tamsin Callaghan, Peter Campbell and Ruth Hogg, provides an overview of the piloting of two such technologies, one in glaucoma and one in neovascular age-related macular degeneration. With an ageing population and many eye conditions needing to be monitored for a lifetime, innovative ways to manage chronic conditions effectively should be welcomed and we look forward to further developments with such schemes.
The pandemic has also had a significant impact on the education sector. Finally, we present two case studies, highlighting some of the ways in which optometric education has been impacted by the pandemic. The first case study, from City, University of London, by Michelle Hennelly and Irene Ctori, focuses on the shift to online learning and teaching, with particular emphasis on postgraduate teaching. The second case study, from the University of Bradford, by Annette Parkinson, Kathryn Webber and Alison Alderson, discusses ways in which undergraduate clinical practice experience has been adapted in response to the pandemic. Both case studies reflect upon and discuss challenges and opportunities that have arisen as a result of these unprecedented changes.
So, as we reflect on the extraordinary experiences in 2020–2021, we need to take stock of what has worked well and what has not, and indeed where more evidence is needed. Embracing evidence-driven change to transition to new ways of working for the benefit of our patients is both exciting and unsettling. One thing is for certain: the transition will be a lot slower than the sudden changes imposed at the start of the first lockdown.
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