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Impact of COVID-19 pandemic on retinopathy of prematurity services in low resource settings

Eye (2023)Cite this article

Subjects

Abstract

Background and objectives

Retinopathy of prematurity is an increasingly important cause of blindness in children in low- and middle-income countries. Timely screening and treatment greatly reduce blindness. This study assessed the impact of the COVID-19 pandemic on ROP services in low- and middle-income countries.

Methods

An online survey with closed and open-ended questions in Microsoft Teams was sent to 304 ophthalmologists providing screening, treatment and/or vitreoretinal services (January 15 to March 12 2021). Categories were used to report impact on services. 28 participants were purposively selected for interview.

Results

184/201 completed forms from 32 countries were received. Two thirds of participants worked in government facilities and 45.6% were paediatric ophthalmologists. A moderate to severe impact was reported by 13% for screening, 9% for treatment and 16% for vitreoretinal surgery with some variation between government, private and not-for-profit sectors. 22% thought services would take a year to recover. Fifteen ophthalmologists from 12 countries were interviewed. Many reported fewer neonatal admissions, and several reported more ROP blind infants once restrictions lifted. Themes associated with services continuing included limited lockdown, autonomy and flexibility, commitment, advocacy and technology. Themes associated with a negative impact include fear and panic, closure of facilities, COVID infection or quarantining of health workers and parents, lack of transport and exacerbation of poverty.

Conclusions

The COVID pandemic had a very variable impact on the provision of ROP services. In some countries where the impact was great, more infants may have become blind from ROP. Lessons can be learnt for planning pandemic preparedness.

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Fig. 1: Impact to COVID 19 pandemic on services for ROP.
Fig. 2

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Data availability

Data are available from the corresponding author upon request. Deidentified individual participant data will not be made available.

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Acknowledgements

We thank all the participants for contributing to this study.

Author information

Authors and Affiliations

  1. International Centre for Eye Health, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK

    Clare Elizabeth Gilbert

  2. Queens’ College, University of Cambridge, Cambridge, UK

    Joshua Todd

Authors
  1. Clare Elizabeth Gilbert
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Contributions

CEG conceptualised and designed the study, collected and analysed the data and wrote the first draught of the manuscript and takes responsibility for the intellectual content. JT assisted in data management and analysis and reviewed and revised the manuscript.

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Correspondence to Clare Elizabeth Gilbert.

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Gilbert, C.E., Todd, J. Impact of COVID-19 pandemic on retinopathy of prematurity services in low resource settings. Eye (2023). https://doi.org/10.1038/s41433-023-02784-6

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