Presentation of Infectious Keratitis to ED during COVID-19 Lockdown

Area of Science:

• Ophthalmology
• Infectious Diseases
• Public Health

Background:

• The COVID-19 pandemic and associated lockdowns significantly altered societal behaviors and healthcare access.
• Infectious keratitis, a serious eye infection, may have been affected by these changes in presentation and management.

Purpose of the Study:

• To compare the presentation, severity, and outcomes of infectious keratitis during the COVID-19 lockdown period with previous years.
• To assess the impact of the pandemic lockdown on patient management and visual recovery.

Main Methods:

• Retrospective analysis of acute infectious keratitis presentations during the March-May 2020 COVID-19 lockdown.
• Comparison of data with the same periods in 2018-2019, including clinical notes, treatment, culture results, surgical interventions, and visual outcomes.

Main Results:

• A 37% decrease in infectious keratitis presentations to the emergency department (ED) was observed in 2020.
• Despite similar risk factors and microbial profiles, cases during the COVID-19 era had poorer visual recovery (LogMAR 0.26 vs. 0.67) and higher rates of surgical intervention (10% vs. 4%).
• Admission rates and use of fortified antibiotics were lower in 2020.

Conclusions:

• The observed reduction in infectious keratitis presentations during lockdown is concerning and may indicate delayed access to care rather than reduced incidence.
• Poorer visual outcomes and increased surgical intervention rates suggest that patients who did present experienced more severe disease or delayed treatment.
• Clear communication strategies are essential to ensure patients and healthcare professionals can access emergency eye care services during future health crises to prevent avoidable ocular morbidity.