(Photo: Courtesy)

In the case of patients with chronic degenerative diseases, whose improvement depends on regularly visiting a doctor in-person, the famous recommendation to “stay at home” shouldn’t be followed dogmatically.

However, the panic surrounding the new coronavirus has caused patients with sight problems at Hospital de la Ceguera in Mexico City, who have underlying health conditions such as diabetes or hypertension, to suffer even greater deterioration to their eyes.

Ana Mercedes García Albisua, head of teaching at this hospital, explains the situation in an interview for Tec Review, and gives further details about this dangerous health scenario.

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From 2000 to 200 patients a day

“At first, we believed that virtual consultations were enough, but after months of living through this pandemic, we realize that many patients have stopped going to face-to-face consultations. This has aggravated their previous conditions or even worsened their prognosis,” she says.

It’s important to remember that chronic degenerative diseases are one of the leading causes of death for the elderly around the world. Having neglected the treatment of these diseases out of fear of SARS-CoV-2 is a problem that’s just beginning to be addressed.

“There are 200 doctors in the hospital, most of us ophthalmologists. We used to see 2,000 patients a day. During the months of April and May, we were treating only around 200 patients a day. This has been increasing slightly and now we’re at 50% of the patients that we treated before the pandemic,” explains García Albisua.

According to this expert, attention was also given over the telephone in April, May, and June, but it didn’t work well.

“We’ve discovered that it’s not the best option and that it’s important to examine the patient because you have to see how the eye is. Unfortunately, that can’t be done over the phone,” she explains.

At Hospital de la Ceguera, they’ve also tried providing consultation via videoconference, but that hasn’t been the solution either.

“We’ve tried to do it via Zoom, but intraocular pressure can’t be measured by Zoom, nor can the retina be seen by Zoom. So, it turns into a very poor consultation,” says García.

This specialist recommends not letting check-ups go by, especially if there’s already a previous diagnosis of a systemic disease affecting the eyes. If not, patients often suffer serious consequences.

“We’ve now witnessed people with further complications because they’ve not been to the doctor’s during the pandemic,” she says.

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The complexities of diabetes and hypertension

One eye condition that patients with diabetes may have is called macular edema.

“These patients have to be injected every four to six weeks with a drug that helps the retinal fluid to be absorbed. So, for those who haven’t been to their consultations, after this length of time, we’re seeing the prognosis has worsened. In some cases, there are scars in the eyes that we can no longer remove,” says the expert.

In diabetics, the eye’s best area of vision is often filled with fluid, which is removed with intravitreal injections. According to García, when this treatment isn’t followed, scars form on the eyeball, which further deteriorates vision.

“There’s another degenerative eye disease called glaucoma. In this case, intraocular pressure is usually high and so patients need to use drops to lower the pressure.”

“They should have check-ups every three or four months. Many people have missed their appointments without knowing if they should continue to use the same medication or not, so their eye pressure has increased a lot. We’re now seeing patients with a lot of complications that maybe at other times would’ve been much easier to treat. They now already have some irreversible after-effects,” explains García.

Ana Mercedes shares that initially in the hospital, they believed that the irregular situation was going to last two or three months and that after that period of time it’d be possible to return to normality.

Unfortunately, this hasn’t happened, since the warning level is still orange. At least in Mexico City, it’s closer to going up to red than going down to yellow.