As the COVID-19 pandemic prompted new concerns for doctors and their patients, Moran鈥檚 ophthalmologists found ways to adapt.
Few medical exams require patients and doctors to sit face-to-face, inches apart, for a period of time. But it鈥檚 an everyday scenario when it comes to ophthalmology.
The COVID-19 pandemic, necessitating physical distancing and personal protective equipment, required John A. Moran Eye Center physicians and their colleagues across the country to innovate and accelerate the use of telehealth.
Before 2020, teleophthalmology visits were mainly used for connecting eye centers with rural communities or in areas around the world, allowing specialists to help local physicians assess a patient鈥檚 condition.
While the technology doesn鈥檛 lend itself to such things as examining peripheral vision or checking eye pressure, it has proven effective for specialties diagnosing apparent conditions such as droopy eyelids.
At Moran, telehealth efforts have taken various forms depending on circumstance.
Adapting to Teleophthalmology
Kathleen B. Digre, MD, is a nationally renowned specialist in neuro-ophthalmology. In her words, she鈥檚 also 鈥渙f a certain age.鈥 So when COVID-19 changed the landscape of health care in
March 2020, she had to pivot, almost overnight, to keep up with patients鈥 needs while keeping herself and her patients safe.
鈥淢y family was worried about exposure鈥攖o the point where they suggested I retire rather than keep working. I got it, but I have too much more to do,鈥 she said. 鈥淚鈥檝e adapted.鈥
From her office at Moran, she monitors an iPad while fellows and residents mask up and evaluate patients in the clinic. They then present their findings to Digre鈥攐ften accompanied by visual test results鈥攙ia a secured video call. If she needs to examine eye movements or pupils or evaluate visual field tests or photos, she can do so virtually.
As much as the system is working, Digre admits she would much rather be in the room with her patients.
鈥淭here have been and will be times when I do absolutely need to see a patient in person,鈥 she said. 鈥淚n that case, I put on full protective gear with a mask and face shield.鈥
The Patient Experience
Linda Bliss is retired and divides her time between Arizona and Wisconsin. For the past five years, she has experienced periodic episodes of light sensitivity and the sensation of 鈥渟eeing a square box鈥 in the middle of her vision. She consulted with several clinics in both of her home states but couldn鈥檛 find a doctor who understood her symptoms. Taking her search online, she found a video of Digre describing her exact symptoms and called Moran right away.
Bliss said she felt 鈥渃ompletely comfortable鈥 with a virtual visit.
鈥淪he sent me an eye exam sheet in advance,鈥 explained Bliss. 鈥淭hen, when we were online, she had me do some eye movements, asked some questions, and told me exactly what was going on. It turns out what I was experiencing was an aura called a 鈥榗ortical spreading depression,鈥 sort of like having a migraine, but without the headache. My experience with Dr. Digre was every bit as good as meeting her in person.鈥
Oculoplastic Consults Thriving
Although virtual consultations were new for Douglas P. Marx, MD, Moran鈥檚 division chief of oculoplastic and reconstructive surgery quickly embraced them.
鈥淎s soon as things shut down in March, I felt vulnerable because I knew so many of my patients were vulnerable,鈥 said Marx. 鈥淭he need was huge, and I didn鈥檛 want to leave anyone without help.鈥
Because almost everything Marx treats鈥攆rom tear duct infections to orbital fractures and other traumas鈥攕tarts with an external, visual assessment, he used virtual visits with ease, relying on them as an excellent screening tool. Marx was then able to view scans remotely to form treatment plans.
鈥淲e kept a lot of people from coming to a place where they could possibly be exposed to other people and found that most of the time they didn鈥檛 need an in-person visit,鈥 said Marx. 鈥淭he patient satisfaction level for these visits ranks consistently high. I think it鈥檚 the future of medicine. I鈥檓 still doing a couple of telehealth visits a day.鈥