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RCOphth COVID-19 guidance on restoring ophthalmology services

Healthcare services are now planning how to move from full lockdown with severely restricted activities to re-opening services. However, there will be continuing and potentially variable levels of restrictions for potentially many months.  Issues related to physical distancing and infection control procedures are also likely to limit available capacity. There will need to be a phased approach and a continuing requirement to prioritise care

This page provides guidance and information on recommendations for the restoration of ophthalmology services.

Resumption of Paediatric Ophthalmology Services during COVID-19
The NHS is intent on recovering services with a resumption of clinical activity set within the constraints of social distancing and minimising the risk of exposure of patients to the COVID-
19 virus which continues to circulate within the community and within hospitals. At the time of writing, the national picture is of COVID-19 infections once again rising and the possibility
of increased restrictions remains. There is a need to adapt services to meet the sometimes conflicting demands of keeping waiting lists and risk due to delays down whilst maintaining
a safe environment. This document provides a guide to assist hospital departments to manage their paediatric ophthalmology service during the pandemic.

Restarting and Redesigning of Cataract Pathways in response to the COVID-19 pandemic
RCOphth and GIRFT have developed joint guidance. High flow cataract surgery needs to resume now to address the backlog and provide patients with a timely service. Failure to do so will compromise the quality of life for patients. Restoration of cataract services will require a detailed review/redesign of the whole cataract pathway to ensure a safe environment for patients and staff. This also gives the opportunity to make changes that will have long-term benefits. This document provides generic guidance on the restarting of cataract services. Individual eye departments should tailor this guidance, taking into account their staffing, infrastructure, the needs of their local population as well as the expectations of local commissioners and regional NHS organisations.

RCOphth UKEGS Glaucoma management plans during recovery phase of COVID 020820
This guidance provides pragmatic advice on recommencing care for glaucoma patients based on clinical expertise from a variety of clinical settings around the UK. The scope of this document is to provide advice for the ‘recovery phase’ rather than the acute lockdown phase. We anticipate this phase will cover perhaps the next 6 months or so. Some of the points will be germane to longer term ‘post COVID-19’ services.

Guidance on restarting Medical Retina Services
This guidance has been developed by a group of medical retinal specialists as requested by the RCOphth in response to the pandemic to provide generic guidance on the resumption of medical retina services. Individual eye departments should tailor this guidance, taking into account their staffing, their infrastructure, the needs of their local population as well as the expectations of local commissioners and regional NHS organisations.

Reopening and redeveloping ophthalmology services during COVID-19 – Interim guidance 290420
This document aims to support decision making and, where possible, provide guidance on how to reopen ophthalmology services after the Covid pandemic lockdown. Its purpose is to support ophthalmic clinical leads, ophthalmic consultants, managers and directors of hospital eye services to plan the recovery phase whilst incorporating service transformation beneficial for long term sustainability of ophthalmology care.

Prioritisation of ophthalmic procedures COVID19 060520
The RCOphth has produced a prioritisation tool to allow services to plan re-opening of procedure and surgical care, which takes into account both the safe and appropriate timing and the risk of harm to patients if this timing cannot be adhered to. Although all patients will need assessment for their individual situation, we hope this will be helpful in planning care and to support discussions with non-ophthalmic, theatre staff and managers in ensuring safe provision of ophthalmic procedures during the recovery phase. A simplified version of this tool will be available in an all specialty resource which will be published shortly by NHS England and we will release a version for outpatient care in the near future.

Prioritisation of ophthalmic outpatient appointments
Guidance to aid ophthalmic services in the prioritisation of their outpatient capacity of their departments.

RCOphth UKISCRS COVID cataract surgery restoring services 070520
This document provides guidance to assist re-opening of cataract services following the COVID lockdown.

Non-contact tonometry and IOL COVID19
Updated guidance in conjunction with the College of Optometrists on the use of non-contact tonometry to measure intra-ocular
pressure during COVID-19.

Principles for the restarting of elective care services PPE and Aerosol Generating Procedures (AGP) principles for ophthalmology
A set of PPE and AGP principles for restarting elective care services.

COVID-19 Urgent Eyecare Service specification (CUES).
Developed in collaboration with the NHS, RCOphth and The College of Optometrists, CUES provides commissioning specification in the management of emergency eye care in the community, ensuring that access to care in the community is managed effectively and that only high-risk patients are appropriately referred into ophthalmology eye service.

Mitigating the Impact on Academic Ophthalmology and Ophthalmic Research

COVID-19 continues to have extensive impact on the healthcare service and this includes research.  There is a current lack of firm commitments about the two key resources, time and funds, required to mitigate the impact of the pandemic. The RCOphth’s document outlines nine key actions and commitments for key stakeholders including the Government and UK ophthalmologists to help sustain ophthalmic research on which patients rely.

Read the Statement paper from the RCOphth Academic subcommittee:

‘Mitigating the impact of COVID-19 on Academic Ophthalmology and Ophthalmic Research’

Read the Academic Leads Group statement on behalf of the Academy of Medical Royal Colleges