University Hospitals of Leicester NHS Trust, UK.
University of Cambridge, UK.
Indian J Ophthalmol. 2023 Mar;71(3):824-829. doi: 10.4103/ijo.IJO_1516_22.
To describe a new pathway for virtual keratoconus (KC) monitoring in the corneal department of a tertiary referral center in the UK during the coronavirus disease 2019 (COVID-19) pandemic.
A virtual outpatient clinic to monitor KC patients (KC PHOTO clinic) was created. All patients from the KC database in our department were included. At each hospital visit, patients' visual acuity and tomography (Pentacam; Oculus, Wetzlar, Germany) were collected by a health-care assistant and an ophthalmic technician, respectively. The results were virtually reviewed by a corneal optometrist to identify stability or progression of KC and discussed with a consultant if needed. Those with progression were contacted by telephone and listed for corneal crosslinking (CXL).
From July 2020 until May 2021, 802 patients were invited to attend the virtual KC outpatient clinic. Of them, 536 patients (66.8%) attended and 266 (33.2%) did not attend. After corneal tomography analysis, 351 (65.5%) were stable, 121 (22.6%) showed no definite evidence of progression, and 64 (11.9%) showed progression. Forty-one (64%) patients with progressive KC were listed for CXL and the remaining 23 patients deferred treatment after the pandemic. By converting a face-to-face clinic to a virtual clinic, we were able to increase our capacity by nearly 500 appointments per year.
In pandemic times, hospitals have developed novel methods of delivering safe patient care. KC PHOTO is a safe, effective, and innovative method of monitoring KC patients and diagnosing progression. In addition, virtual clinics can increase the clinic capacity tremendously and reduce the need of face-to-face appointments, which is beneficial in pandemic conditions.
在 2019 年冠状病毒病（COVID-19）大流行期间，描述英国一家三级转诊中心角膜科中虚拟圆锥角膜（KC）监测的新途径。
创建了一个虚拟门诊病房来监测 KC 患者（KC PHOTO 门诊）。纳入了我科 KC 数据库中的所有患者。每次就诊时，由一名医疗助理和一名眼科技术员分别收集患者的视力和断层扫描（Pentacam；Oculus，德国韦茨拉尔）。结果由角膜视光师进行虚拟审查，以确定 KC 是否稳定或进展，并在必要时与顾问讨论。如果发现进展，将通过电话联系患者，并安排进行角膜交联（CXL）。
从 2020 年 7 月到 2021 年 5 月，共有 802 名患者受邀参加虚拟 KC 门诊。其中，536 名（66.8%）患者就诊，266 名（33.2%）未就诊。经过角膜断层扫描分析，351 名（65.5%）患者稳定，121 名（22.6%）无明确进展证据，64 名（11.9%）显示进展。41 名（64%）进展性 KC 患者被列入 CXL 名单，其余 23 名患者在大流行后推迟了治疗。通过将面对面门诊转换为虚拟门诊，我们的门诊容量每年增加了近 500 个预约。
在大流行时期，医院已经开发出安全的患者护理新方法。KC PHOTO 是监测 KC 患者和诊断进展的安全、有效和创新的方法。此外，虚拟门诊可以极大地增加门诊容量，减少面对面预约的需求，这在大流行期间是有益的。
