Delivering eye care services in a pandemic

Specsavers continues to support of Lions Outback Vision Van through The Fred Hollows Foundation during COVID-19 by donating a portion of our glasses sales. Here, the team at The Foundation explains how its services were impacted by COVID-19 and what they look like now.

Thank you to Specsavers for your continued support of The Fred Hollows Foundation and our partner, Lions Outback Vision, during this difficult time.

As you would be well aware – delivering eye care services during a pandemic presents a number of challenges. This was felt right across the country, including in Western Australia with the Lions Outback Vision team and their Vision Van.

The COVID-19 pandemic meant that Western Australian state borders were closed, and still are, as well as many inter-regional borders, such as between the Pilbara and Kimberley. Most remote Aboriginal communities were also closed to prevent the spread of the virus to these at-risk populations.

The Vision Van was off the road for 41 days, with 10 clinics cancelled, predominantly across the Kimberley and Pilbara regions. Some patients were able to be seen by resident doctors in Broome and some exemptions were given to cross-regional borders to attend injection clinics, such as for macular degeneration treatment. To reduce the movement of these patients by up to 50%, specialists were able to administer higher doses with the intravitreal injections, covering six weeks instead of four.

Seven regional surgical lists were cancelled with regional hospitals only beginning to reschedule cataract surgery, considered an elective surgery, in late June. Due to these high numbers of elective surgeries cancelled, the number of days available for ophthalmology is likely to be reduced until the end of the year. This will have an impact on the annual number of cataract surgeries for Western Australia.

During this ‘down time’, an audit of all patient records was completed to identify those areas with longer waitlists for services or where patients had missed more than one appointment. The Aboriginal Eye Health Coordinator reviewed all Aboriginal patient records and rang patients who had not attended appointments to identify the barriers. The main barriers included transport problems, fear of the needles, cultural commitments, length of time taken for appointments (including travel), and patients being out of town when the clinics were held.

Doctors contacted high-risk patients to check on their eye health and made sure that those in greatest need were elevated to the top of the next available clinic lists.

Lions Outback Vision also established an on-call service for patients to call if they had any severe eye issues. The Broome-based doctors at the new regional hub were able to assist patients who needed urgent treatment that might normally have had to have been transferred to Perth.

The Lions Outback Vision Van was able to start up again on 11 June 2020 with additional days added to the schedule to support the increased number of patients, particularly across the Great Southern and Goldfields regions. One of the outcomes of the interruption to service was an increase in the uptake of services, and a decrease in Do Not Attends when services resumed with 100% attendance at some locations.

The Vision Van is now back to its normal schedule with additional clinic days held in the communities of highest need. This partly allows for catching up with patients who were missed between March and June but also takes into consideration more stringent processes implemented to increase social distancing and additional time for cleaning down of surfaces after each patient.

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