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RESIDENTS CORNER
Year : 2020  |  Volume : 3  |  Issue : 5  |  Page : 90-91

Blindness during the coronavirus outbreak


Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong

Date of Submission29-Feb-2020
Date of Decision05-Mar-2020
Date of Acceptance06-Mar-2020
Date of Web Publication25-Apr-2020

Correspondence Address:
Sunny Chi Lik Au
9/F, MO Office, Lo Ka Chow Memorial Ophthalmic Centre, Tung Wah Eastern Hospital, 19 Eastern Hospital Road, Causeway Bay, Hong Kong

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_60_20

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How to cite this article:
Au SC. Blindness during the coronavirus outbreak. Cancer Res Stat Treat 2020;3, Suppl S1:90-1

How to cite this URL:
Au SC. Blindness during the coronavirus outbreak. Cancer Res Stat Treat [serial online] 2020 [cited 2020 Jun 1];3, Suppl S1:90-1. Available from: http://www.crstonline.com/text.asp?2020/3/5/90/283316



On December 31, 2019, cases of pneumonia of unknown etiology from Wuhan city were first reported to the World Health Organization China Country Office. Later, on January 7, 2020, the Chinese authorities identified the causal agent to be a novel strain of coronavirus. It had been 3 days since the first death by coronavirus disease 2019 (COVID-19) occurred within the city, and nearly half of the patients were absent from their specialty outpatient clinic appointments. The clinic was rather quiet, with only a few patients in the waiting hall, making the news channel broadcasting on the television conspicuous. There were scenes of people frantically queuing up in pharmacies and supermarkets for limited supplies of face masks, alcohol-based hand rubs, bleach solutions, food, and all other kinds of daily necessities.

As the ocular oncology clinic resident, I started to phone up the patients who had missed their appointments, one by one. As an application of telemedicine under the local COVID-19 outbreak,[1] I did not only call them up to reschedule their appointment but also inquired about their illness, current symptoms, new complaints, medication compliance, and reason for non-attendance. The most commonly cited reason for non-attendance was the fear of acquiring COVID-19 during hospital visits. Some patients mentioned that they were on self-quarantine after traveling to endemic areas. Interestingly, half a dozen patients mentioned that they were busy queuing up for face masks as we spoke on the phone.

After several telemonitoring and tele-supervision phone calls,[2] the next case file I held was that of a 19-year-old female patient, Madam X, suffering from bilateral blindness from retinoblastoma after radiotherapy and enucleation of one eye.[3] I took a deep breath before placing the call with great empathy.

It was a mobile number, and the patient answered the call rather quickly. I believe her smartphone was well within her reach, as is the case with other visually impaired people nowadays, treating smartphones to be their essential visual aids equipped with all kinds of audio assisting applications.[4]

I said, “Good afternoon, this is Dr. Au from the hospital clinic speaking. May I speak with Madam X, please?”

“Yes, this is she,” a female voice answered.

I enquired about her condition and symptoms, particularly about her empty orbital socket, and reminded her about the orbital prosthesis hygiene.[5] She was an inactive case with the prosthesis fitted for almost 3 years, and there was nothing new to add to her management plan. When I enquired about the reason for nonattendance, she started to share with me the difficulties faced by visually impaired people because of the COVID-19 local outbreak.

As coronaviruses can survive on all kinds of surfaces, including grab handles on public transportation, handrails, and elevator buttons in shopping mall, they all become susceptible to virus inoculation. Therefore, people with vision impairment, who usually perceive their surroundings by touching and hearing,[6],[7] are more vulnerable to infection.[8] Things became more difficult for these people as familiar places became unfamiliar to them. In addition, many patient centers for the visually impaired were closed to avoid human transmission through clustering, further limiting their information access through braille translation services.

The patient broke into tears and continued to share her concerns. She said, “The elevator buttons are now all covered in thick plastic sheets designed for easy cleaning, and I cannot feel the braille on the buttons accurately. I can only hear people coughing around me, but I am not sure whether they are wearing a face mask or how far they are from me. I am scared that I might get the infection when traveling in a crowded train compartment.” She then complained about her unhappy experience during the metro trip to pharmacies over the neighboring district. “Face masks are not available in the usual places, and we have to go around different districts for purchasing merely a box. As we cannot see, we are always at a disadvantage when it comes to queuing up and getting our daily necessities from the shelves.”

Her worry was clearly reflected in her weeping, as toward the end of the teleconsultation she said that she only had a handful of masks left and could not afford to use one to travel to the hospital for her appointment. With great consideration to her situation, at the back of my mind was our clinic's tight supply of face masks and how our healthcare workers were trying hard to limit the usage. Feeling helpless, I comforted her with some COVID-19 updates from the literature, advised her to keep alert to the latest COVID-19 developments, and wished her good luck for purchasing more face masks for her everyday needs.

With a sinking heart, I continued my teleconsultation with other patients. Day after day, more and more patients expressed their fear of COVID-19 and a few more patients with cancer and vision impairment put forth similar concerns.

The psychological fear that diseases like COVID-19 foster is much more infectious than the disease itself, and the inability to discern, either physically or spiritually, can be terrifying. As doctors, our healing hands are blessed to give hope to our patients and are not confined to the walls of our consultation rooms. Touched by my encounter with patients with cancer and vision impairment, I explored donation channels that work for the cause and arranged for home delivery of hand rubs and face masks to such patients.

It is necessary to acknowledge that oncological patients with physical disability are socially vulnerable and should not be neglected during an epidemic.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Au SC. Revisiting the role of telemedicine under the 2019 novel coronavirus outbreak. Eur J Geriatric Gerontol 2020. [Ahead of print]. [Doi: 10.4274/ejgg. galenos. 2020.282].  Back to cited text no. 1
    
2.
Sirintrapun SJ, Lopez AM. Telemedicine in cancer care. Am Soc Clin Oncol Educ Book 2018;38:540-5.  Back to cited text no. 2
    
3.
Dimaras H, Corson TW, Cobrinik D, White A, Zhao J, Munier FL, et al. Retinoblastoma. Nat Rev Dis Primers 2015;1:15021.  Back to cited text no. 3
    
4.
Akkara JD, Kuriakose A. Smartphone apps for visually impaired persons. Kerala J Ophthalmol. 2019;31:242-8.  Back to cited text no. 4
    
5.
Choudhury M, Banu F, Natarajan S, Kumar A, Tv P. A multidisciplinary approach for rehabilitation of enucleated sockets: Ocular implants with custom ocular prosthesis. Cureus 2018;10:e2201.  Back to cited text no. 5
    
6.
Legge GE, Madison C, Vaughn BN, Cheong AM, Miller JC. Retention of high tactile acuity throughout the life span in blindness. Percept Psychophys 2008;70:1471-88.  Back to cited text no. 6
    
7.
Voss P. Auditory spatial perception without vision. Front Psychol 2016;7:1960.  Back to cited text no. 7
    
8.
Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect 2020;104:246-51.  Back to cited text no. 8
    




 

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