We can’t tell you when it will be safe to go back to the hair salon, when the kids will return to school or when you can hug your grandparents again. But we can say that your next trip to the ophthalmologist will be different. That’s because ophthalmologists are devising new office procedures to prevent the spread of COVID-19.

As California "reopens," the California Academy of Eye Physicians and Surgeons in partnership with our national counterpart the American Academy of Ophthalmology (AAO) want to share how ophthalmologists are working to protect their patients and staff.

In March, CAEPS and the AAO urged ophthalmologists to immediately stop routine surgical and in-office visits to preserve protective equipment such as masks and to mitigate the risk of spreading COVID-19, the illness caused by the novel coronavirus. Although both groups made recommendations to curtail routine care — in turn based on recommendations from the Centers for Disease Control and Prevention and public health officials — the decisions to reopen more normal practice are being handled locally and regionally.

Ophthalmologists are ready with new procedures. Here is what you should expect to see:

• The clinic may ask you to wait outside or in your car instead of in the normal waiting room. This is to protect you, the other patients and the office staff from possible virus exposure in crowded waiting areas and until you can be screened.
  
• The clinic is likely restricting the number of people who enter. If you do not need someone to be there with you, do not bring anyone to your appointment.
• Expect to see hand sanitizer when you enter the building and in the waiting room and exam rooms.
• Expect to be asked to wear a mask. Here’s a video on how to properly put on and take off your mask. You won’t be alone. The staff as well as all visitors should wear a mask.
• Waiting room chairs -- when used -- will be spaced out to accommodate social distancing. The office may also have made arrangements or adjustments for additional waiting areas to prevent crowding.
• You will not see magazines, clip boards, or other high-touch materials that could help spread the virus.
• Cleaning will occur more frequently throughout the clinic.
• As usual, exam rooms and equipment will be thoroughly cleaned before every patient.
• Expect to be asked a series of questions to determine your risk profile.
• Expect everyone to have their temperature taken, whether they are at high risk of being infected or not.
• Your eye doctor may use a special plastic breath shield on the slit lamp machine they use to look into your eyes. They may also wear a plastic shield over their eyes in addition to a mask.
• Your doctor may ask you to wait to speak until after your eye exam is complete. He or she can then talk with you and answer questions when they can be a safe distance from you.

As you can imagine, there may be a backlog of patients who postponed care, so you may have to wait for an appointment. Also, the additional precautions required in operating rooms will likely result in fewer surgeries performed each day.

"Ophthalmologists are doing everything possible to ensure patients are comfortable with the updated processes and techniques. We recognize these are challenging times, but those challenges must be balanced with your needs as a patient," said Amin Ashrafzadeh, MD, CAEPS President and a  Cornea and Refractive Surgery specialist practicing in Modesto.

“Our primary responsibility as physicians is to our patients’ safety and health,” said Dianna Seldomridge, MD, clinical spokesperson for the AAO. “It’s the core of the medical profession. If you have questions or concerns about coming into the office, give your ophthalmologist's office a call. As always whatever is done will be guided by what’s best for you.”

Age-related Macular Degeneration (AMD) is one of the leading causes of blindness over age 50, affecting about 2.1 million people nationwide. Early diagnosis and treatment are the keys to preventing vision loss.CAEPS and the American Academy of Ophthalmology (AAO) are therefore educating the public about the facts on AMD. 

AMD is a degenerative disease that happens when part of the retina called the macula is damaged. It’s the part of the eye that delivers sharp, central vision needed to see objects straight ahead. Over time, the loss of central vision can interfere with everyday activities, such as the ability to drive, read, and see faces clearly.

Ophthalmologists – physicians who specialize in medical and surgical eye care – have more tools than ever before to diagnose the disease earlier, and to treat it better. But these advances cannot help patients whose disease is undiagnosed, or patients who are unaware of the seriousness of their disease. People’s lack of understanding about AMD is a real danger to public health. A recent study showed that most people with AMD don’t realize it’s a chronic health issue that requires regular attention for the rest of their lives. 

Both Academies offer these seven steps to help people take control of their eye health:

• Get regular comprehensive medical eye exams. AMD often has no early warning signs, so getting regular comprehensive eye exams from an ophthalmologistis critical to diagnosing and treating the eye disease in its early stages. Both CAEPS and the AAO recommend that adults with no signs or risk factors for eye disease get a baseline eye disease screening at age 40 — the time when early signs of disease and changes in vision may start to occur. By age 65, the recommended exam frequency is every one to two years, even in the absence of symptoms or eye problems.
  
• Quit smoking. Numerous studies show smoking increases the risk of developing AMD, and the speed at which it progresses. Smokers are twice as likely to develop macular degeneration compared with a nonsmoker.
  
• Eat a well-balanced diet. Many studies demonstrate that eating a diet rich in fruits, vegetables, and nutrient-packed foods, such as salmon and nuts, may reduce the risk of AMD. Researchalso suggests that patients who ate fresh fish, an important source of omega-3s, were at lower risk of developing AMD.
  
• Take the right kind of vitamins. Vitamins can delay progression of advanced AMD and help people keep their vision longer if they have intermediate AMD or advanced AMD in one eye. But make sure it’s the right combination of vitamins. A recent study found that some of the top-selling products do not contain identical ingredient dosages to eye vitamin formulas proven effective in clinical trials.
  
• Exercise regularly. Exercising three times a week can reduce the risk of developing wet AMD by 70 percent. Studies also show that physical activity may lower the odds of both early and late-stages of AMD.
  
• Monitor your sight with an Amsler Grid. This simple, daily routine takes less than one minute and can help people with AMD save more of their vision. Using this grid is essential to finding any vision changes that are not obvious, so you can report them to your ophthalmologist.
  
• Know your family’s eye health history. If you have a close relative with AMD, you have a 50 percent greater chance of developing the condition. Before your next eye exam, speak with your family about their eye health history. You may need more frequent eye exams based on your family history.
  

“Most people understand the importance of annual medical examinations," said Rahul N. Khurana, MD, Immediate Past President of CAEPS, and a clinical spokesperson for both CAEPS and the AAO. “However, we often forget that our eyes also need regular evaluation by a medical doctor. Degenerative diseases, such AMD, can now be successfully treated, but early detection is imperative to avoid lasting consequences."

To learn more ways to keep your eyes healthy, visit the American Academy of Ophthalmology’s EyeSmart^® website.

Some of the more common age-related eye diseases include age-related macular degeneration, cataract, diabetic retinopathy and glaucoma. Early detection and treatment of these conditions can help to save sight before vision loss occurs. Ophthalmologists – the physicians that specialize in medical and surgical eye care – recommend a dilated comprehensive eye exam as the best way to prevent these conditions from becoming debilitating.

U.S. Adults Do Not Get Eye Exams as Often as Recommended
The survey results emphasize a need for more education about the importance of medical eye exams. Findings showed that 64 percent of adults had at least one or more of the following issues with their eyes or vision:

• difficulty seeing at night;
• blurry vision;
• reading up close;
• flashes of light;
• red, watery eyes; and,
• double vision.

Despite experiencing some level of impairment, only 13 percent admitted they had been seen by an ophthalmologist.

How Often Do Adults Need Eye Exams?
Both Academies recommend that a healthy adult get a baseline eye exam at age 40, even if they have no history of eye problems or eye disease. Those who have chronic conditions, such as diabetes or high blood pressure, may require more frequent exams.

"Sight is precious, and catching problems early can make a big difference in maintaining vision for the long term, says Rahul N. Khurana, MD, a retina specialist and CAEPS President.

Those over age 65 who may be concerned about cost or lack of health insurance, the AAO’s EyeCare America program offers eligible seniors a comprehensive eye exam and up to one year of treatment at no out-of-pocket cost.

One in four Americans age 65 or older has diabetes, putting them at increased risk for vision loss and blindness. Fortunately, diabetes-related vision loss is largely preventable with regular care. Yet studies have found a majority of Medicare beneficiaries with diabetes do not get the necessary eye exams despite the fact that the exams could be covered under their existing insurance.