COVID; Eyes and Vision
Don’t lose sight of eye health during the COVID-19 pandemic
June 24, 2020
In early 2020, hospitals around the country began limiting in-person visits for health care appointments that were deemed "elective" and nonurgent or nonemergent due to the COVID-19 pandemic.
Ophthalmology care straddled the line between urgent/emergent and elective care and that resulted in many eye care visits being delayed. Most of our services are critical to preserve, prevent loss of, or restore vision. This includes ongoing care for degenerative eye conditions such as glaucoma, cataracts, diabetic retinopathy, etc.
While we postponed or rescheduled in-person visits for a few months beginning in March, some patients have asked whether they can safely delay their appointments until fall. Unfortunately, many eye diseases progress silently or seem tolerable now but can quickly progress into irreversible damage or emergencies.
The risk of delaying eye care is simply too high, which is why on June 1, the UT Southwestern Department of Ophthalmology resumed in-person visits with extensive COVID-19 precautions and protocols in place. Our staff is taking every step to ensure your safety.
Another important reason not to put off your vision care is that this novel coronavirus has proven unpredictable. If another wave of infections arrives in North Texas in the fall, we might have to pause ophthalmology services again.
Right now, there is a window of opportunity, so please consider scheduling your vision appointment to preserve, prevent loss of, or restore your vision.
Below, I've compiled answers to a few of the most frequently asked questions on COVID-19 and ophthalmology, as well as a list of eye symptoms and conditions that shouldn't be ignored.
COVID-19 and eye care: FAQs
What is UT Southwestern doing to keep me safe?
Long before the COVID-19 pandemic, we designed our outpatient care facilities and our hospital to reduce the risk of spreading infection. We are able to space out seating for appropriate physical distancing and you can access multiple hand-sanitizer stations throughout our offices. We sterilize seating areas frequently, as well as all surfaces and equipment between exams.
During the pandemic, all doctors, staff, patients, and visitors are wearing masks. We screen all patients and visitors for COVID-19 for fever, symptoms, or potential exposure. If you are scheduled for surgery, we will test you for the virus a few days before your procedure – even if you do not have symptoms – to reduce potential exposure to others.
On top of these protocols, we have adopted a more streamlined exam process. In-office visits now include only what must be done in person, such as exams or testing. A few days before your visit, we'll call you to update our records regarding your symptoms and health history – no more forms to fill out in the office.
Progressive Eye Conditions: Why They Can't Wait
Delaying eye care during the COVID-19 pandemic, particularly for progressive conditions, could result in vision loss. Our specialists take every precaution to keep patients safe as they return for expert ophthalmology care.
Can I do telehealth visits?
Many serious eye conditions such as glaucoma rage silently inside the eye, causing no noticeable symptoms until the condition damages your vision. Early diseases can progress quickly, and there is no way to predict how slow or fast your unique condition might advance.
To identify these conditions and preserve your vision, we need to measure the pressure of your eye and get an effective look inside. The only way to do that is with special equipment in our clinic. We will dilate your pupils to allow the clearest view. Then we will select the appropriate equipment or technology to gather the information we need.
Sometimes all we need is to look at the interior eye structure with a slit lamp (a lighted microscope). We'll also use fairly standard equipment such as the phoropter – the "owl eyes" machine – to test your vision strength or various machines to measure your cornea or the pressure within your eye. Equipment for patients to allow these assessments is not available remotely.
Other times, we need more advanced technology, such as retinal angiopathy and optical coherence tomography (OCT). OCT shows us the layers of the retina, giving us detailed information to slow the disease process and potentially allow us to prevent vision loss. We can also pair OCT with electrophysiology, a technology that helps measure how well your brain responds to light that enters the eyes.
While UT Southwestern is offering telehealth options in many other areas, the tests and technologies necessary for precision ophthalmology care simply don't translate via video conferences or telephone conversations. To prevent or potentially reverse vision damage, it's important we see you in our offices, which are safer than ever.
Related reading: How we use advanced technology in eye exams
Do not delay care for these symptoms and conditions
Progressive eye problems can evolve into serious, vision-threatening conditions over time. In some cases, symptoms may indicate a serious eye disease or other health problem.
Contact your ophthalmologist right away if you experience any of these new or worsening symptoms:
- Blurry vision: You may need new glasses, or you might be developing cataracts or macular degeneration. In some patients, blurry vision accompanies neurological conditions such as Parkinson's disease or stroke.
- Eye pain: Sore eyes can be caused by foreign objects in the eye, allergies, or eye strain. Eye pain can also be caused by a chronic condition such as glaucoma or dry eye.
- Floaters: Floaters are usually caused by age-related changes to the vitreous, a jelly-like substance in the back of your eye. Floaters, or clumps of the condensed vitreous or cells, have been linked to inflammation or tumors in the eye. Floaters can indicate the development of holes in the retina, which can lead to detachment.
- Redness and irritation: These symptoms could indicate seasonal allergies, an eye infection, injury, or exacerbation of other chronic conditions.
- Vision loss: Gradual loss can be the result of chronic conditions such as cataracts, glaucoma, diabetes, or macular degeneration. Sudden vision loss can signify a serious infection, retinal detachment, vascular occlusion, or a neurological condition.
Your ophthalmologist may not be able to predict how quickly your eye condition will progress. However, routine examinations can guide us to help slow it down and preserve or improve your vision.
If possible, do not postpone routine care for these chronic conditions:
The American Academy of Ophthalmology (AAO) estimates that approximately half of U.S. patients 75 and older have cataracts, which cause cloudy vision in one or both eyes. Though children can be born with cataracts, approximately 90% occur in seniors. The cataracts can also occur due to other eye conditions, eye injuries, or as a result of diabetes.
Cataracts typically develop slowly. You may notice cloudy or blurry vision, poor night vision, glare around headlights or lamps, and faded colors. See AAO's cataract vision simulator.
Treatment: Early cataracts often don't require surgery. Stronger glasses or contacts can help improve your vision. But if the cataracts interfere with daily life, surgery can help. The surgeon will replace the defective lens in your eye with a new one. Our advanced techniques are blade-free and reduce your recovery time. We harness the power of artificial intelligence and virtual reality to give you a more precise outcome. We also have the ability to correct astigmatism and/or presbyopia (short arm syndrome) with special intraocular lenses. Learn more.
Type 2 diabetes is the leading cause of blindness in patients age 40 to 60. Patients with diabetes are at increased risk for diabetic retinopathy, which damages the blood vessels in the retina, and diabetic macular edema, which is a buildup of fluid in the center of the retina. Patients may experience blurry vision, poor night vision, floaters, inflammation, or blind spots.
Treatment: Your ophthalmologist can administer medications directly into the eye to reduce swelling or provide topical medication to reduce inflammation. Some patients can benefit from laser surgery to shrink or seal off abnormal blood vessels, decrease swelling, or remove or replace fluids within the eye. Learn more.
With this condition, the eyes make too few or low-quality tears to lubricate the eyes. This weakens the fluid layer that helps protect the eye from drying out or becoming infected. If left untreated, dry eye can lead to deteriorating vision or blindness.
Treatment: Eye drops, ointments, or eyelid cleansing wipes can relieve mild dry eye symptoms. For severe or persistent symptoms, you may need surgery to block the tear outflow channel and keep your natural tears in your eye longer. Learn more.
More than 3 million people in the U.S. have glaucoma, and most are 40 and older. Glaucoma is a silent stealer of vision – it causes no symptoms early on, so patients at risk for glaucoma or those with the disease should not skip eye pressure checks. The various types of glaucoma cause excessive pressure within the eyes and damage the optic nerve.
You may experience, but not commonly, red eyes, sudden and severe eye pain, light sensitivity, and blurred vision as the disease progresses into side (peripheral) or total vision loss.
Treatment: Prescription eye drops can lower pressure and prevent nerve damage. Selective laser trabeculoplasty (SLT) can help reduce pressure in the eyes by 20% to 30%. Depending on your condition, you may benefit from minimally invasive glaucoma surgery (MIGS) to help the eyes more effectively drain away excess fluid. Learn more.
Posterior vitreous detachment or retinal detachment
PVD occurs when the vitreous gel that fills the back of the eye collapses and pulls away from the retina. Blurred vision, floaters, or flashes of light can be the first signs of PVD. PVD is more common in patients older than 40. Risk increases if you've had a recent eye surgery or if you have had a PVD in the other eye. Without treatment, the condition can progress into a retinal tear or detachment, in which the retina pulls away from the eye, resulting in loss of peripheral vision.
Treatment: Most cases resolve on their own and require follow-up in case the disease progresses. In severe cases, patients with torn or detached retinas may need laser or incisional surgery to preserve their vision. Learn more.
The progressive eye disorder often affects patients over age 60, so it is often called age-related macular degeneration (AMD). AMD damages the macula, which is the center of the retina at the back of the eye. Patients may have fuzzy or blurry vision, see wavy lines, or have dark or empty areas in the center of their vision field. AMD causes difficulty driving, reading, and seeing faces, as well as performing household and work duties. Over time, patients may experience total central vision loss.
Treatment: There is not yet a cure for AMD, but we can help slow its progression and improve your quality of life. Monitoring with regular, comprehensive eye exams is important to stay ahead of the curve. Depending on the type and severity of your condition, the doctor may recommend a clinical blend of nutritional supplements, medication injections in the eye, or laser therapy to control the growth of abnormal blood vessels, or photodynamic therapy – light-sensitive medication that forms clots around abnormal blood vessels. Learn more.
Parkinson's disease or Alzheimer's disease
These conditions affect the central nervous system and also can damage vision-related areas of the brain or eye such as the optic nerve and retinal cells. Approximately 75% of patients with Parkinson's may experience mild eye symptoms such as blurry or double vision, eye strain, light sensitivity and uncontrolled eye movements. Those with Alzheimer's may have trouble recognizing shapes, seeing color, or processing visual motion. There are many recent studies on how Alzheimer's affects the eyes, though the exact path and extent of damage is not yet understood.
Vision symptoms from both diseases increase the risk of injury from accidents such as falling or getting burned while cooking.
Treatment: UT Southwestern's ophthalmologists work closely with our neurology colleagues to preserve our patients' function, including vision. Your doctor may prescribe specialized lenses or adjust your medications according to your unique needs. You may also need eye drops or a functional eye plastic surgery called blepharoplasty to raise droopy eyelids and control symptoms such as dry eye or excessive blinking. Through our ongoing clinical trial research, we are working to develop early testing and gene therapies to prevent and improve neurological vision symptoms. Learn more.
Pediatric eye issues
Lazy eye (amblyopia) and misaligned eyes (strabismus) must be managed early in childhood to avoid vision loss and psychological consequences. Lazy eye occurs when a nerve pathway from the deviated eye does not properly develop or is blocked by a pediatric cataract, sending blurry images from that eye to the brain. The brain learns to stop paying attention to that eye over time. Lazy eye can also be caused by a droopy eyelid. With strabismus, either eye turns up, down, or to one side, causing the brain to ignore that eye to avoid double vision.
Children may endure teasing or feelings of isolation due to the condition, which can cause psychological trauma. As adults, poor vision, low confidence, or appearance bias can reduce the patients' career options and quality of life.
Treatment: Treatment typically includes special glasses that improve image focus and wearing an eye patch to increase strength in the weaker eye. Some children need surgery to remove cataracts, correct a droopy eyelid, or straighten out the eyes. Learn more.
A few closing thoughts
Healthy vision is a major factor in our overall wellness, particularly as we age. It allows us to not only see family and friends, continue to work, and also maintain mobility and independence.
Most eye conditions can lead to deterioration and loss of vision and impact life in many ways. Routine visits to the ophthalmologist are critical to preserve, prevent loss of, and restore vision.
During the recent pandemic, these visits fell into the nonurgent category and were canceled or delayed. Fortunately, we have a window to offer exams and procedures right now in a safe environment that we have made available to our patient population.