Neglected eye health and low number of surgeries due to pandemic: retinal, cataract and pterygium procedures fell

The 48-year-old patient had developed diabetes in her youth and now presented with complete blindness, retinal detachment, vitreous hemorrhage, and retinal failure. She underwent surgery, not to restore her vision or to reform her diagnosis, but rather so that she would not develop neovascular glaucoma and painful blind eye (irreversible damage to the eyeball with discomfort).

This is one of the most complex cases treated by ophthalmologist Patricia Lira, a specialist in retina and macula surgery, and promoter of a crusade to make visible the neglect of eye health as a result of the pandemic.

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According to the specialist, the most common illnesses in the country are refractive errors (which occur when the shape of the eye does not allow it to focus well), cataracts (clouding of the lens), ocular degeneration, glaucoma (a disease that damages the optic nerve) and diabetic retinopathy, which occurs as a result of damage to the blood vessels in the tissue at the back of the eye.

“Patients with diabetes with eye problems, which appear when the chronic pathology is poorly controlled, have perhaps been the furthest behind due to the pandemic. There are even patients who debut with visual problems such as cataracts, without knowing that they are diabetic. And that partly because the control of the patient has not been given. They come for care when their cases are well advanced. In addition, during the health emergency, appointments were postponed and surgeries were reduced”, Lira clarifies.

The National Institute of Ophthalmology (INO), an institution specializing in eye health of the Ministry of Health, details that in 2019 1,014 posterior vitrectomy surgeries were performed —to treat vitreous hemorrhage like the patient in question, or retinal detachment and diabetic retinopathy, hemorrhage vitreous—but the number fell to 405 in 2020 and 480 in 2021, from 553 in 2022.

Before the pandemic, there were 3,692 phacoemulsification surgeries (to treat cataracts, the most frequent cause of blindness), although the number fell to 891 in 2020 and 980 in 2021, compared to 3,576 in 2022.

Similarly, 757 pterygium surgeries (abnormal growth of the conjunctiva on the cornea) in 2019, which fell to 356 in 2020 and 283 in 2021, compared to 760 interventions in 2022. Likewise, glaucoma surgeries sank by 44 in 2021, up from 793 in 2022.

“These figures invite us to make an impact on the preventive issue and to discuss the condemned work of the specialists who treat specific patients,” the expert remarks. For example, it strikes me that endocrinologists don’t talk much about eye problems in patients with diabetes, when the first thing that should be done is an eye fundus, to evaluate the retina, optic nerve, and macula. It is decisive because, between juvenile and type 2 diabetes, the former is the most aggressive with the eyes and all the white organs of this disease”.

Lira also mentions that, after the second year of the pandemic, there has been an increase in cases of myopia, especially in developing children. “The computer, tablets, books, video games, paintings, all activities that involve being close, favor the appearance of this eye disease. Before it appeared in children under eleven years old, now it appears from the age of eight ”, he laments.

He adds that, in this context, other pathologies such as conjunctivitis and dry eyes have also developed or aggravated, especially with the arrival of summer.

“By being concentrated in front of the screen, we blink less and secrete fewer tears. That’s when burning eyes appear, visual fatigue and difficulty focusing, among others,” says Lira, who envisions that the most drastic consequences could be seen in about three decades: people whose vision degenerates at an early age.

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