key: cord-0954494-ezvafgtt
authors: Ting, Darren Shu Jeng; Krause, Sherine; Said, Dalia G.; Dua, Harminder S.
title: Comment on: The Impact of COVID-19 on Individuals Across the Spectrum of Visual Impairment
date: 2021-05-11
journal: Am J Ophthalmol
DOI: 10.1016/j.ajo.2021.04.036
sha: b441e5b58b8bd131f21d9680318be5e289c46c9b
doc_id: 954494
cord_uid: ezvafgtt

nan

We read with great interest the recent paper published by Shalaby et al. 1 The authors compared the perceptions and implications of COVID-19 across individuals with varying degree of visual impairment (VI) in an Indian population. They observed that blind participants more commonly perceived vision as a risk factor for contracting COVID-19 and were more concerned about access to healthcare. In addition, at the time of their publication, the authors pointed out that there was no evidence in the literature that had examined the effect of VI on various aspects of life in relation to COVID-19. On this front, we would like to draw the authors' attention to a paper that was published by our group last year on a similar area where we had evaluated the psychosocial impact of COVID-19 pandemic on people with VI in the UK. 2 Several similarities and discrepancies were noted between the two studies, of which some are worthy of further comments.

In May 2020, we conducted an online survey among 325 participants with varying degree of VI. Overall, we observed that COVID-19 pandemic lockdown had significantly impacted on the mental health (46%), loneliness (46%), social life (85.3%), anxiety related to hospital visits (55.1%), and fear of sight loss due to delayed review/treatment (46%). Similar to Shalaby et al., 1 we noted that individuals with moderate VI were most likely to experience mental health issues such as depression and anxiety (3 times more likely than individuals with no/mild VI). In addition, we observed that individuals of working age group (18-64 years) were more likely to experience mental health issues than older individuals (>65 years), suggesting that age (and employment status) are important factors to be considered when assessing the impact of COVID-19. Notably, Shalaby et al. 1 reported a positive correlation between the extent of VI and increased age in their study, though the potential confounding effect of age on various significant outcomes linked to the extent of VI was not examined.

Potentially, the authors could consider performing multivariable logistic regressions (for several important outcomes) to account for the independent effect of age, extent of VI, level of education, and other factors. 2 In addition, while they observed that individuals with moderate VI were more concerned about health, the fear of further sight loss was similar across all age groups and extent of VI in our study. The discrepancy between the two studies might be related to the difference in the timing of administrating the survey (in relation to the timing of national lockdown), healthcare systems, culture, and level of education.

COVID-19 pandemic had led to significant disruption to the delivery of ophthalmic services. 3 Tele-medicine, with potential integration of artificial intelligence, has shown promise as an effective solution for improving the workflow efficiency and tackling the unprecedented crisis in ophthalmology. [4] [5] [6] As individuals with VI are more commonly affected by the implications of COVID-19 pandemic, it is important to ensure that the new digital technologies need to be made as user-friendly as possible for this vulnerable group of individuals.

The impact of COVID-19 on individuals across the spectrum of visual impairment

Psychosocial impact of COVID-19 pandemic lockdown on people living with eye diseases in the UK. Eye (Lond)

The impact of COVID-19 pandemic on ophthalmology services: are we ready for the aftermath?

Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak

Digital technology, telemedicine and artificial intelligence in ophthalmology: A global perspective

Artificial intelligence for anterior segment diseases: Emerging applications in ophthalmology