Impact of COVID-19 pandemic on ophthalmic presentations to an Australian outer metropolitan and rural emergency department: a retrospective comparative study.

Background: To analyse ophthalmic presentations to an outer metropolitan and a rural emergency department (ED) during the first wave of the COVID-19 pandemic in New South Wales (NSW), Australia.

Methods: A retrospective comparative study of ophthalmic emergency presentations to Campbelltown Hospital (fifth busiest NSW metropolitan ED; population 310,000) and Bowral and District Hospital (rural ED; population 48,000) before and during COVID-19 was conducted. Patient demographics, triage category, referral source, diagnosis, length of stay, departure status, and follow-up location were assessed from coding data between March 1st to May 31st in 2019 and 2020, corresponding to the peak case numbers and restrictions during the first wave of the COVID-19 pandemic in NSW. Differences before and during COVID-19 were analysed using chi-squared tests or independent sample t-tests.

Results: There was no change in ophthalmic presentations at Campbelltown (n = 228 in 2019 vs. n = 232 in 2020; + 1.75%, p = 0.12) and an increase at Bowral (n = 100 in 2019 vs. n = 111 in 2020; + 11%, p < 0.01) during COVID-19. Urgent ophthalmic presentations (Triage Category 3) decreased at Bowral (p = 0.0075), while non-urgent ophthalmic presentations (Triage Category 5) increased at both hospitals (Campbelltown p < 0.05, Bowral p < 0.01).

Conclusions: There was no change in the total number of ophthalmic presentations to an outer metropolitan and an increase to a rural ED during the first wave of the COVID-19 pandemic in New South Wales, Australia. A change in the type of ophthalmic presentations at these peripheral EDs suggest that a high demand for ophthalmic services remained despite the pandemic and its associated gathering and movement restrictions. A flexible healthcare delivery strategy, such as tele-ophthalmology, may optimise patient care during and after COVID-19.