Our Frontline Providers
With hospital emergency departments nationwide now facing or preparing for the full impact of the COVID-19 pandemic, optometry's role in frontline, essential care is more important than ever—and doctors of optometry are heroically meeting the challenge in their home communities.
According to a finding by the AOA's Health Policy Institute, treating eye emergencies at the eye doctors' offices has the combined potential to divert up to 10% of patients away from emergency departments. Doctors of optometry across the country are filling this need and adapting practices to guidance from the Centers for Disease Control and Prevention (CDC) and the AOA on delivering urgent and emergent care.
Medicare's emergency expansion of telehealth services, which includes doctors of optometry and was the subject of an AOA webinar in March, is providing an important connection point with patients as up to 80% of Americans are facing lockdown orders and other restrictions on daily life.
"I've never been prouder of optometry and our essential care role than during this national health care emergency," AOA President Barbara L. Horn, O.D., says. "AOA doctors serving thousands of communities are courageously stepping forward and serving as the most trusted and needed access point for eye health and vision care."
Doctors of optometry are helping fight the spread of COVID-19 by serving in the West Virginia National Guard. SUNY College of Optometry announced Tuesday it's adopting telehealth technology to conduct virtual visits with patients at its University Eye Center, an alternative in order to stop the spread of the virus. And other doctors of optometry, frontline primary eye care providers, are finding unusual ways to deliver care.
Calm in the storm
Amid the COVID-19 pandemic, Doug Totten, O.D., of Michigan, is down to a skeleton staff in his practice. Patients are seen on an emergency basis. And even then, great precautions are taken. Social distancing is practiced, patients fill out a COVID-19 questionnaire, and the office is routinely and meticulously cleaned.
Nevertheless, the practice stopped seeing patients for routine or general patient care on March 18, heeding guidance from the CDC. And a few days later, the state's governor issued a stay-at-home order and the doors were locked to patients, the dispensary was shut down and only essential staff kept on.
"Office traffic is greatly reduced since the directives have been released," says Dr. Totten, president of Lakeshore Professional Eyecare. "For example, our main office usually has 30 patient encounters per day. We have averaged about four (urgent) encounters per day since the stay-at-home directives were released.
"We're hanging in," Dr. Totten says. "It's gone very smoothly. We feel it's our responsibility to be available to care for our patients even if we're offering limited services. Urgent care centers have been busy, so it's difficult for a patient to be seen for an eye problem when the centers are focused on other health issues at this time."
"Besides there is no better option for a patient with an urgent eye issue than to see their doctor of optometry," he adds. "It's been rewarding, and the patients have been very grateful to be seen with really few other alternatives to receive care."
'Blessed and privileged to serve'
Around the country, doctors of optometry in the U.S. Public Health Service and the National Guard are being deployed in the fight against the virus.
For instance, three members of the West Virginia Association of Optometric Physicians (WVAOP) serve in the National Guard, including its Vice President Nathan Stevens, O.D. John Wiles, O.D., is the Joint Task Force Medical Commander for the West Virginia National Guard coronavirus support. Dr. Stevens is administrative officer for the task force.
"Our mission is to keep the joint forces (Air Force and Army) safe and healthy while providing medical knowledge and aid to the state of West Virginia during the pandemic," Dr. Stevens says. "For the Coronavirus Support Joint Task Force, we are called into different roles outside of 'optometrist.' However, our optometry degrees provide us a sound medical background along with critical thinking and problem-solving skills, which we use daily in this Joint Task Force role. Since we are unable to see patients (for routine care) during this pandemic, we both feel blessed and privileged to serve the state of West Virginia and our country in this role."
Also serving in the West Virginia National Guard is Shawn Sammons, O.D., the association's secretary-treasurer.
The pandemic has most optometric practices in flux, but doctors of optometry still play an important role by keeping ocular emergencies out of the ER, says WVAOP President Mark Cinalli, O.D. "This underscores the vital role doctors of optometry play in the overall health care system. We are so proud of these doctors who have stepped up to serve their country, especially in this time of need."
Still delivering frontline care
We're living in uncertain times and doctors of optometry aren't immune to the pandemic's stressful spread.
"We have been closed for two weeks," Andrea Thau, O.D., of New York—a hotbed for the COVID crisis—said this week. "We are making decisions daily about whether a patient needs to be seen in the office. If we need to go in and handle an emergency, we will."
Beyond emergencies, Dr. Thau has found other ways to care for patients—through phone calls, texts and virtually. Her practice welcomes patient calls and email on topics big and small. One patient had a concern about a swollen eye. Another needed a prescription refilled. She even fielded a question about N95 masks.
Significantly, Dr. Thau has taken this opportunity to educate her practice's thousands of patients not only about eye health but also about COVID-19—its symptoms and preventing its spread.
Doctors of optometry are not only primary eye care providers but also vested in public health, she says. They are aware of their patients' overall medical history and deliver care accordingly.
"We take care of a lot of people with complex, systemic diseases," Dr. Thau says. "We know who is at greatest risk if they were to get ill. People trust us as doctors of optometry. Patients appreciate us reaching out to them."
Access AOA guidance, resources on COVID-19
The AOA continues to closely monitor all developments and actively participate in U.S. public health discussions regarding the COVID-19 response to keep optometry apprised of the latest information and guidance. Doctors of optometry need not only understand the risks and current public health situation but also have the latest clinical recommendations and guidance for informed patient care.
Considering the seriousness and evolving nature of this pandemic, the AOA launched a comprehensive COVID-19 updates page where optometry can quickly locate the latest updates and guidance from the AOA and U.S. public health authorities. This resource page includes:
- AOA COVID-19 Resources Webinar II—What doctors of optometry need to know about just-enacted Federal crisis relief legislation, including details on CARES, loans, leave and more
- The AOA HPI's regularly updated statement, "Doctors of Optometry and COVID-19" and FAQ.
- AOA advocacy updates on current federal issues affecting optometry.
- AOA guidance on rendering telehealth services to Medicare patients during this pandemic.
- CDC and WHO guidance for health care providers.
- Current developments and situation reports on COVID-19.
The AOA supports the CDC's patient care guidance issued March 17 to combat further community spread and a wider outbreak, and reaffirms that doctors of optometry are frontline providers of essential care in this nation. Based on the immediate health needs of a patient, doctors of optometry can and should use their professional judgement to determine the timing and course of care, including assessing patient-expressed urgency, necessary preventive care and the monitoring and refilling of prescriptions.
Doctors of optometry should be cognizant of the COVID-19 situation in their communities and stay attuned to the latest care recommendations.