Three months since the lockdown, dentists and ophthalmologists are exercising a great deal of caution as they slowly restart elective surgeries.
As the specialists prepare for the new normal in dental and ophthalmology practices, office bearers at the state unit of Indian Dental Association as well as Maharashtra Ophthalmology Society say they are following strict protocol that includes triaging, temperature check, finding the travel history of the patient, and advising them to defer surgical procedures if not essential.
With coronavirus cases on the rise, dentists, as well as patients undergoing dental procedures, are at high risk of cross-infection. Dental aerosols can present a health risk as most procedures require close contact with the patient’s oral cavity, saliva, blood, and respiratory tract secretion. Many patients who are asymptomatic may be carriers, and the Union Ministry of Health and Family Welfare has strongly advised precautionary measures to be taken.
For the ophthalmologists as well, guidelines on triage and government advisories for use of personal protective equipment and other precautions to be taken in the OPD and operating room have been issued.
“Elective surgeries can be taken up after all safety precautions have been taken by the dentists,” Dr Nitin Barve, president of the state unit of Indian Dental Association said. While Dr Barve has a dental clinic at Paud Road in Kothrud (green zone), he admitted it was challenging to treat patients via tele-dentistry. “For the initial three weeks post lockdown, patients were given online consultations. However, it is difficult to treat unless one physically examines the patient,” he said.
Dr Yashwant Ingle, president of IDA, Pimpri-Chinchwad unit, said telephonic consultations help the doctor understand the extent of the problem. “Equipment like sanitiser fumigation machines and high vacuum suction units are being used to ensure safety of patients and staff at the clinic,” Dr Ingle said.
While tooth extractions and emergency surgeries have been underway, only a few dentists have started taking up prosthetic and orthodontic work. “We are gradually opening up to other dental procedures only after ensuring FTOCC – fever check, travel history, and occupation of the patient, as well as if they have come in contact with a Covid patient and are from any containment cluster zones,” Dr Mohit Kheur, prosthodontist and professor at Rangoonwala Dental College said.
Since June 1, however, the patient flow has resumed slightly at most small nursing homes. Though the turnaround time between patients is at least 45 minutes as the entire equipment is set up – be it a dentist or ophthalmologist’s clinic – the equipment has to undergo deep cleaning.
Dr Parikshit Gogate, president elect of Maharashtra Ophthalmology Society said that for two and a half months, there was absolutely no work. “My clinic is located at Tadiwala road, which is near the containment zone. Prior to the Covid crisis, there would be at least 40 to 50 patients daily in the OPD, which trickled down to two to five patients. While there has been a slight increase in the number of patients, it was also important to allay fears of staff at the clinic. Lens induced glaucoma or bleeding in the eye are among procedures that have to be treated, but some surgical procedures like cataract operations are performed if essential,” Dr Gogate said.
According to Dr Aditya Kelkar, managing director at National Institute of Ophthalmology, doctors are spending more time in the OPD, but there are fewer patients. “Presently, we are at 25 per cent of our normal workload, and one of the reasons could also be that most of our patients are above 60 years old, and are hesitant to reach out for consultations at the clinic. However, after using PPE kits and spreading appointments, we have resumed cataract and glaucoma surgeries,” he said.
Dr Rahul Deshpande, medical director at H V Desai Eye hospital said they were strictly following safety measures and were performing eye operations. However, free eye check-up camps have not commenced yet, he added.
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