To help patients during COVID-19, some ophthalmologists are meeting patients in clinic parking lots to check IOP and review care.

COVID-19 and social distancing have kept many patients out of the waiting room, but that hasn’t stopped some ophthalmologists from meeting their glaucoma patients — in the parking lot.

These “curbside” glaucoma checks usually involve a fully masked and gloved ophthalmologist checking the patient’s IOP while they sit, masked, in their parked car outside the clinic.

PARKING LOT CHECK-IN

Jody Piltz-Seymour, MD, an ophthalmologist at Valley Eye Professionals in Huntingdon Valley, Pa., began her curbside services with a telemedicine visit with patients to address any questions or concerns ahead of time, with a curbside glaucoma check scheduled about a week later. Recently, though, she moved away from the telehealth visit as her office laptop is able to access a patient’s electronic record from the practice parking lot, via secure Wi-Fi.

The night before the visit, the practice calls the patient to handle check-in and copays and to give a description of their car so a technician knows to look for it. The next day, the patient drives to the parking lot, where the technician guides their car to a specific examination spot.

The technician, Dr. Piltz-Seymour and the patient are all masked for their interactions. The technician checks the patient’s vision with a chart calibrated for use at 5 feet, after which Dr. Piltz-Seymour checks their IOP with a handheld tonometer and perform a penlight eye exam.

For some recent curbside patients, Dr. Piltz-Seymour has asked patients to sit in a lawn chair in case she is not tall enough to reach into their vehicle.

A similar procedure is used by Paras Shah, MD, of the Chicago area’s NorthShore University HealthSystem. Patients receive an initial call to schedule a curbside IOP check and arrive in the practice parking lot a few days later. After calling the main office to check-in, a technician in mask and goggles approaches the patient’s car and uses a handheld tonometer to measure IOP. Upon returning to the clinic, the tech records the IOP in the practice’s EMR; the physician reviews this information and performs a telehealth visit in the following days to discuss the results with the patient.

PATIENT RESPONSE

Both physicians say that the program has been very popular with their patients.

“They feel safer not being exposed to other patients in the office, along with our staff. They can also take comfort in knowing what their IOPs are, in a low-risk manner, and can still get their glaucoma managed during this pandemic,” says Dr. Shah.

Dr. Piltz-Seymour estimates that her clinic has seen about 40 patients over the course of three curbside clinics. The glaucoma check-ups are especially helpful for elderly patients, says Dr. Piltz-Seymour, so she can check on them and review their treatment plans. Being able to talk to patients in their vehicles also means she can speak with them for longer than she could in the exam room, where there is a greater risk of infection. Overall, she says, the system has worked great, and she plans to continue performing weekly curbside exams through October.

Dr. Shah sees these clinics as “a great option for all patients,” especially the elderly who are at higher risk of COVID. Dr. Shah says his clinic has seen 90 to 100 patients over the course of 5 weeks. They have been so successful for NorthShore, he says, that there are plans to expand curbside services to include fundus photography for asymptomatic diabetic patients. OM