Patient and Resource Management of Emergency Walk-In Clinic During a COVID-19 Pandemic State Lockdown

Vichar Trivedi,1 Yasaira Rodriguez Torres,2 Vaama Patel,2 Pradeepa Yoganathan2 1Wayne State University School of Medicine, Detroit, MI, USA; 2Department of Ophthalmology, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, MI, USACorrespondence: Pradeepa YoganathanDepartment of Ophthalmology, Kresge Eye Institute, Wayne State University School of Medicine, 4717 St. Antoine Street, Detroit, MI, 48201, USAEmail deepayoganathan@gmail.comObjective: To gather data on the most common chief complaints, diagnoses, in-office procedures, and surgeries that presented to the Kresge Eye Institute’s Emergency Clinic in Detroit, Michigan during the COVID-19 state lockdown period to provide data for staff and resource allocation in future waves.Design: Retrospective study.Participants: All patients 18 years or older presenting for ophthalmic consultation to the Kresge Eye Institute Emergency Walk-in Clinic between March 23rd and April 17th, 2020 were included in the study.Methods: All patients who met the inclusion criteria were indexed based on their initial encounter date and patients were stratified by urgent and non-urgent ophthalmic reasons for evaluation. Patient demographics, medical history, chief complaint, diagnosis, and need for surgical intervention and procedures were obtained from the electronic medical records.Results: The most common diagnoses were corneal disease (31.4%), followed by vitreoretinal disease (25.3%), orbit-eyelid pathology (8.8%), and glaucoma-related issues (8.8%). The most common office procedure was intravitreal injections (37.5%) followed by foreign body removal (21.9%), and pan-retinal photocoagulation laser (21.9%). Retina surgery was the most common emergency surgery representing 73.3% of the total, the second most common was keratoplasty (13%).Conclusion: Future implementation of protocols for triaging based on chief complaints can aid in protecting patients and expanding the role of distanced assessment with telemedicine. Suggested management of an emergent clinic requires availability of retina and cornea specialists given the majority of visits, procedures, and surgeries were related to their area of expertise.Keywords: retina, cornea, COVID 19, SARS-CoV-2 infection, COVID-19 pandemic, ophthalmology, clinical protocol, coronavirus disease-19