ADVICE AND GUIDANCE ACCESS TO HEYEH FOR OPTOMETRISTS DURING COVID-19 OUTBREAK
Dear Colleagues
You will no doubt be aware that given the current COVID-19 pandemic, the eye hospital is running an emergency / urgent care only service.
As all routine elective ophthalmic activity has been suspended in NHS Trusts and ISTCs for at least the next few weeks, as per NHSE and RCOphth instructions, there will be patients needing access to urgent HES care during this period.
In HEYEH we have been performing an extensive validation exercise for all patients who were already booked into clinics, and rearranging their planned follow-up accordingly.
All patients are being phoned by the admin team to explain the situation and the need for us to take this drastic action, in order to protect our population and to enable preparedness for the escalating pressures within HEYEH. Where needed, clinicians are phoning patients (ie post-operative patients) and performing telephone/video triage for new urgent referrals, where possible.
Understandably there will be anxious patients, many of whom will obviously be delayed in their planned follow-up. Inevitably some will contact yourselves for advice and reassurance. Please be assured our normal referral and advice channels will still be operational as outlined below. We are aware of the difficulties folk have had at times getting through to the department and we have taken extensive steps to improve our comms.
During normal working hours (0900-1700):
ARC phone line to covering Ophthalmology doctor for GP/Optometrist/Emergency Dept
01482 816625 (Eye Casualty Doctor)
01482 608788 and 816658 (Nurse Triage)
Out of hours:
On Call Ophthalmology doctor via switchboard
Moorfields Eye Hospital have produced some guidelines to help guide the appropriate triage of patients during this period. Hopefully the following guidelines, subdivided broadly into subspecialty and adapted from the MEH protocol, will be of help to you in your managing of patients during this period.
These are extremely challenging times for all of us involved in looking after the eye health of our patients, having to make difficult decisions regarding urgency of care balanced against the risk to life.
At the Eye Hospital we are all so appreciative of the day in day out care your provide to our population, and together we can work to ensure we do all we can to look after our patients though this difficult time.
With very best wishes
Keep safe
The HEYEH Ophthalmology team
Subspecialty |
Immediate phone advice |
Urgent email / Advice and guidance within 24h |
Glaucoma |
Symptoms / signs of AACG IOP >38mmHg |
IOP >30mmHg |
Retinal |
Macula-on, or recent (<24h) macula-off retinal detachment (symptomatic – recent shadow, reduced vision +/- floaters photopsia) Sudden loss of vision – presumed CRAO |
Acute loss of central vision / distortion –wet AMD suspected Significant recent onset floaters +/- photopsia Macula-off retinal detachment Vitreous haemorrhage Central retinal vein occlusion |
Adnexal / Lid |
Acute onset proptosis / Rapidly worsening TED Suspected orbital cellulitis |
Suspicious lid lesion – cancer suspected Periocular infection – eye unaffected, vision and eye movements unaffected – patient otherwise well |
General |
Pain and reduced vision within 2 weeks of eye injection / surgery Amaurosis fugax, with or without headache New onset headache with visual loss or diplopia |
|
Neuro / Strabismus |
Acute onset of binocular diplopia Acute ptosis Acute Horners or dilated pupil |
|
Ocular Oncology |
|
Mass lesion, suspicious naevus – (if possible with images to nhs.net address) |
Cornea |
Corneal ulcer – pain, redness, loss of vision, hypopyon (please see separate advice re contact lens wear during pandemic) |
Abrasion – no sign of associated infection / clear cornea Dendritic ulcer |
Paediatrics |
Orbital / preseptal inflammation as above
|
Reduced vision in one eye under 7y Reduced vision in both eyes |
|
|
|