COVID-19: Ophthalmology service guide (Devon)

April 2020

*Please note the urgent advice contact telephone number for Torbay Hospital has been updated*

Scope

This information provides guidance on the management of ophthalmology patients across Devon during the COVID-19 pandemic. The information is based on national guidance from the Royal College of Ophthalmologists, the College of Optometrists and NHS England.

Key messages

All non-urgent elective activity has been temporarily suspended
Emergencies, urgent care and sight saving operations are available as normal
Units have redesigned services and workloads to support social distancing as much as possible for the safety of staff and patients
Primary eye care providers within optical practice teams are able to support hospital ophthalmology and primary care teams in the response to the pandemic

2WW referrals

Only patients suspected of cancer should be referred under the 2WW pathway.

Conditions with specific guidance

There will be patients who need to be seen and treated urgently. These may include, but are not limited to, those with the following conditions:

Exudative 'wet' age-related macular degeneration
Proliferative diabetic retinopathy
Retinal detachments
Severe sight threatening ocular trauma
Advanced or rapidly progressive glaucoma
Uveitis
Ocular oncology
Retinopathy of prematurity (screening and treatment)

Decisions regarding such patients must be based on their risk of significant harm if treatment is delayed.

Urgent advice and referrals

Urgent Care will continue to be provided in line with normal triage processes on a case by case basis. All these services can be accessed by primary care, optometrists, and via A&E.

Eye units have expanded their triage facilities to support their A&E services and are available for advice and making urgent appointments on the contact numbers below.

Plymouth Hospital (REI):

Monday – Friday, 08:30 to 18:00: 01752 439330

Saturday – Sunday, 09:00 to 13:00: 01752 439330

All other times: On call ophthalmologist via switchboard: 01752 202082

Torbay Hospital:

Monday – Friday, 8:00 to 18:00: 07818 562917

All other times: On call ophthalmologist via switchboard tel: 0300 456 8000 (local rate) or 01803 614567

North Devon Hospital:

General urgent referrals: ndht.eyes@nhs.net

Monday – Friday, 8:00 to 20:00: 01271 322461

All other times: On call ophthalmologist via switchboard: 01271 322577

Royal Devon and Exeter (WEEU):

Monday – Sunday, 09:00 to 18:00: 01392 402399

All other times: On call ophthalmologist via switchboard: 01392 411611

Many optometrists and opticians continue to provide modified services in the community.

Optometry referrals will where possible follow this flow chart to link into hospital eye services:

The Royal College of Ophthalmologists: Ophthalmology and Optometry Patient Management during the COVID-19 Pandemic

Routine referrals

All new routine referrals will be clinically triaged and will either be added to a waiting list or, if appropriate, A&G will be given.

Please ensure that a practice-based system is in place to check daily for returning referrals with A&G.

Prior to making a routine referral, please ensure that any appropriate Policy or CRG has been reviewed and that all the suggested investigations and management options have been considered.

Existing new and follow-up routine appointments have been cancelled and changed to telephone / video consultation where appropriate.

All non-urgent elective operations have been suspended temporarily.

All units are actively processing follow up appointments to balance the risk of sight loss against the need for social distancing.

Necessary outpatient consultations are being delivered remotely by telephone or virtual consultation where possible.

Where remote consultation is not possible all units continue to run sight saving services re-designed to support social distancing measures where possible.