Telemedicine can only go so far. For something like eyecare, you usually have to make an ‘in person’ visit to the doctor’s office. But in an effort to see patients and keep infection from spreading, a Blacksburg Ophthalmologist will be doing drive-through appointments. Robbie Harris has more.
When the first reports of the Coronavirus came out early this year. Ophthalmologist Dr. Parisa Farhi was fast out of the gate with strict protocols to prevent spreading it: Phone consults instead of in-person follow ups, no handling of paper, handwashing and more handwashing.
She and her team had been watching disturbing updates coming out of Wuhan, China and Italy. “And, we said, okay, the numbers are coming at about 15% mortality rate for people who are over 84, people who are over 70 about 7% to 10% and about 16% of people are ending up needing hospitalization, among all age groups.”
When the first reports of the coronavirus came out early this year. Ophthalmologist Dr. Parisa Farhi was fast out of the gate with strict protocols to prevent spreading it: Phone consults instead of in-person follow ups, no handling of paper, handwashing and more handwashing.
She and her team had been watching disturbing updates coming out of Wuhan, China and Italy. “And, we said, okay, the numbers are coming at about 15% mortality rate for people who are over 84, people who are over 70 about 7% to 10% and about 16% of people are ending up needing hospitalization, among all age groups.”
She did the math and came up with a plan for her practice, Farhi Eyecare in Blacksburg. “We see about 40 patients a day and (older people are) our average patient population. And if we are not careful, if a patient brings something in, or if the staff or I am a silent shedder, then the results will be catastrophic.”
So, she went with the model that says, ‘assume everyone you see in the office is a carrier’ given the exponential infection pattern seen in this disease. She went to limited hours, limited staff, she hung clear shower curtains around their cubical. But she could not shutter her practice because, while some eye conditions are not urgent, others are.
“We have a lot of patients who have glaucoma, which is a silent disease at first, until the very end when it's too late and the damage it causes is irreversible.”
That’s what led Farhi to the idea of creating a drive through protocol for checking eye pressure. A tent will be set up in the parking lot and she’ll treat patients through their windows.
“We had to get a little bit creative. I had to look for covers for my instruments that were easily accessible, soft enough and appropriate size to be able to put my arm in somebody's car. We came up with bread bags that are a particular plastic composition.”
Anything that touches the patient will be discarded after that use.
The drive through plan has its challenges, weather being the main one, but it has enough advantages to be worth it, she contends.
Outdoors, “the air is fresher and of course the patients must be wearing, masks when they come through. I'm going to be in my full gear,” double respirators obscuring her face, “except I'm going to have a little bit more protective cover in addition to what I normally have.”
It's too soon to tell if drive through ophthalmology will catch on. Dr. Farhi shared her protocols for her practice with the American Academy of Ophthalmology. Dr. David Glasser is with the organization. “That’s one way to isolate,” he says, when told about Dr. Farhi’s drive through plan.
Glasser says ophthalmology has probably been the most heavily impacted medical practice affected by COVID-19 in terms of reduced surgeries and office visits. “But I think we're, we're not going to see waiting rooms filled with 30 or 40 or 50 patients, shoulder to shoulder, like there used to be before it has happened.It's going to be a little bit of a dance figuring out what works and what doesn't. We’ve never been faced with something like this, at least not in our lifetimes.”
