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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 60  |  Issue : 1  |  Page : 19-22

Corona warriors-front-line workers with varied ophthalmic presentations during the lockdown in COVID-19 pandemic in a tertiary care center in South India


Department of Ophthalmology, MS Ramaiah Medical College, Bengaluru, Karnataka, India

Date of Submission26-Jun-2021
Date of Decision07-Dec-2021
Date of Acceptance15-Dec-2021
Date of Web Publication22-Mar-2022

Correspondence Address:
Dr. M Ramya
Department of Ophthalmology, M. S. Ramaiah Medical College, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_95_21

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  Abstract 


Aims and Objective: To analyze the various ophthalmic presentations among the Corona warriors-front line workers during the COVID-19 pandemic. Materials and Methods: This was a cross-sectional observational study conducted at a medical college hospital in the ophthalmology department. All the front-line workers including doctors, postgraduates, interns, staff nurses, Hospital staff, health-care workers (HCWs), Police personal were involved in the study after obtaining informed consent. Twenty-five front-line workers were examined after taking necessary safety precautions. A thorough history was taken regarding ocular symptoms. Best-corrected visual acuity was recorded using Snellen's visual acuity chart. Anterior segment evaluation was done using a slit-lamp examination, fundoscopy done. Medical management was done in 23 patients, and emergency surgeries were performed in two patients who required surgical management. Results: Among 25 front line workers mean age was 34.5 years, males were 15, females were 10. There were 20 HCWs among whom 8 were doctors, 2 postgraduates, 4 interns, 6 nurses. The other 3 were accredited social health activist worker, Bruhat Bengaluru Mahanagara Palike workers, hospital cook, and 2 police personal. Twenty-one workers had varied ocular manifestations which were managed medically. Two workers had retinal pathology and underwent retinal barrage laser. Two policemen had road traffic accidents and underwent emergency surgery. Conclusion: Corona warriors-front line workers are leading the battle against COVID-19 from the front, putting their own lives at risk with selfless determination for the sake of saving lives, they truly are our heroes in these challenging times. During this tough phase, they were working relentlessly and faced spectrum of the ophthalmic issue. It is, therefore important to monitor these front-line workers for any eye problems and ensure that timely treatment is given. Hence their safety is our responsibility. This is a tribute to all the front-line workers working tirelessly during the uncertain pandemic.

Keywords: Accredited social health activist, Bruhat Bengaluru Mahanagara Palike, corona warriors, frontline workers, health-care workers


How to cite this article:
Ksheeraja Y, Ramya M. Corona warriors-front-line workers with varied ophthalmic presentations during the lockdown in COVID-19 pandemic in a tertiary care center in South India. TNOA J Ophthalmic Sci Res 2022;60:19-22

How to cite this URL:
Ksheeraja Y, Ramya M. Corona warriors-front-line workers with varied ophthalmic presentations during the lockdown in COVID-19 pandemic in a tertiary care center in South India. TNOA J Ophthalmic Sci Res [serial online] 2022 [cited 2022 Jul 2];60:19-22. Available from: https://www.tnoajosr.com/text.asp?2022/60/1/19/340379




  Introduction Top


The world health organization declared the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 a pandemic on March 11, 2020.[1]

India reported the first case of COVID19 on January 30, 2020, in the Southern coastal state of Kerala. When the SARS COV-2 virus reached India, the nation was looking up to the healthcare workers (HCWs) and other front-line workers as its saviors! The HCWs accepted this challenge positively and converted themselves into “CORONAWARRIORS.” HCWs include not only doctors and nurses but also ward assistants, laboratory technicians, radiology technicians, operation theatre attendants, physiotherapists, occupational therapists, sweepers, accredited social health activist (ASHA) workers, multipurpose workers, and ambulance drivers as frontline workers.

Apart from HCWs even other professionals who helped during the pandemic and worked relentlessly were police, housekeeping personal.

The lockdown which was implemented nationwide changed the life of everyone. The brave “Corona warrior” too had to adopt to the new lifestyle and the changes in the working environment. The challenges faced by the HCWs were multifaceted and multifactorial.[2]

Frontline workers in COVID areas experienced undue stress of contracting infection themselves as well as carrying it back home to infect the near and dear ones. The absence of household helpers due to lockdown was an additional burden for working women. Some HCWs including doctors and paramedical staff faced harassment in residential areas due to fear of the spread of the disease. Many of them also had problems in traveling to the workplace due to a lack of public transport. Hence, many HCWs in the public sector opted to stay away from their families in the temporary stay facilities provided by the administration.

Despite all the necessary precautions, some of the HCWs did get infected with COVID either within the hospital or outside.

The untimely death of Dr. Li Wenliang, a Chinese ophthalmologist who tried to warn fellow practitioners about the potential outbreak of a virus was one of the first corona warriors to succumb to the deadly virus. Unfortunately, he was accused of making false claims and misleading the public.

It is, therefore, vital that front-line workers wear proper protection. Second, it is important to monitor these front-line workers for disease and implement appropriate containment measures.

Now, the COVID warriors have a sense of accomplishment after doing their best during this unforeseen global pandemic.

In this study, we aimed to analyze the number of front-line workers who presented to the ophthalmology department in a medical college COVID hospital with various eye problems during the lockdown in COVID-19 pandemics.


  Materials and Methods Top


This was a cross-sectional observational study conducted at a medical college COVID hospital in south India. All the front-line workers including doctors, postgraduates, interns, staff nurses, Hospital staff, ASHA HCWs, Police personal, Government HCWs were involved in the study after obtaining informed consent. All the patients were examined in the ophthalmology outpatient department after taking necessary safety precautions. A thorough history was taken regarding the onset, duration, and characteristics of ocular symptoms. Best-corrected visual acuity was recorded using Snellen's visual acuity chart. Anterior segment evaluation was done using a slit-lamp examination. Fluorescein staining was done in subjects with corneal involvement and fundus examination was done.

Medical management was done in few patients accordingly, and emergency surgeries were done in few patients who required surgical management after giving a swab for RT PCR test.

Written Informed consent was taken by the frontline workers for the RTPCR test and surgery.

Inclusion criteria

  1. Police
  2. Government health workers-ASHA workers, Bruhat Bengaluru Mahanagara Palike (BBMP)
  3. Doctors
  4. Postgraduate students
  5. Interns
  6. Nurses
  7. Hospital staff including cooks, sweepers.



  Results Top


Among 25 front-line workers mean age was 34.5 years, males were 15, females were 10.

There were 20 HCWs among whom 8 were doctors, 2 postgraduates, 4 interns, 6 nurses. Other 3 were ASHA workers, BBMP workers, hospital cook and 2 police personal.

Twenty-one workers had varied ocular manifestations including conjunctivitis, hordeolum externum, uveitis, etc., which were managed medically.

Two workers had retinal pathology and underwent retinal barrage laser.

Two policemen had Road traffic accident and underwent emergency surgery pre and post operative picture of one of the police with globe rupture is as shown in [Figure 1].
Figure 1: (a) Preoperative picture of police- open globe injury with iris prolapse. (b) Postoperative after primary globe repair

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The following table shows the details of diagnosis and management of eye injuries in two policemen [Table 1].
Table 1: Eye injuries in policemen – corona warriors

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A total of 20 HCWs were included in the study.

History, diagnosis, and management details are depicted in [Table 2].
Table 2: Eye manifestations in health care workers - Doctors, postgraduates, interns, and nurses

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Other frontline warriors were ASHA workers, BBMP workers, hospital cooks.

Their history and clinical presentation and management details are shown in [Table 3].
Table 3: Eye problems in various front line warriors

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  Discussion Top


India reported the first case of COVID-19 on January 30, 2020, in the Southern coastal state of Kerala in a student who had a travel history to Wuhan, China, followed by two more similar cases on February 2 and 3.[3]

People across India and around the globe are largely confined to their homes with businesses and educational institutions all shut down in an attempt to contain the virus, where as doctors, HCWs, and medical staff are leading the battle against COVID-19 from the front. Putting their own lives at risk with selfless determination for the sake of saving lives.

The sacrifice that front-line workers are making for the safety and welfare of humanity is priceless and deserves lifelong gratitude on our end. Most importantly, we must reassess the value HCWs and take care of their safety too.[4]

Feelings such as fear, uncertainty are common in any biological disaster and may act as barriers to the health care team's interventions. Maintaining the worker's mental health is essential to controlling infectious diseases. The development and implementation of evaluations, support, treatment, and mental and other health services are shown to be crucial points and vital to the health care response to the COVID-19 outbreak.[5]

Conjunctivitis has been reported to be the primary ocular manifestation of COVID-19, with the prevalence ranging from 0.8% to 31.6% of patients. In the largest retrospective study involving 1099 patients with laboratory-confirmed COVID-19 from 552 hospitals across 30 provinces in China, the rate of conjunctivitis is 0.8%.

Wu et al. reported 12 (31.6%) of 38 COVID-19-positive patients had conjunctival hyperemia, chemosis, epiphora, or increased secretions, and attributed these to conjunctivitis, although only 2 patients had positive RT-PCR detected on the conjunctival swabs.[6]

Although the 2003 SARS-CoV crisis did not create quite so severe a spread of infection in the United States, it was noted that HCWs accounted for about 20% of all patients with infections. Most recent figures show that HCWs make up 9% of Italy's COVID-19 cases, and more than 100 HCWs have died from COVID-19 infections, including, at the last count, more than 60 doctors (in Italy). Figures in other countries will continue to increase.[7]


  Conclusion Top


Corona warriors-front line workers are leading the battle against COVID-19 from the front, Putting their own lives at risk with selfless determination for the sake of saving lives, they truly are our heroes in these challenging times.

During this tough phase, they were working relentlessly and faced spectrum of ophthalmic issues which had to be managed medically or surgically.

It is, therefore, crucial that the front-line workers wear proper protection, also important to monitor these front-line workers for any eye problems. To ensure that timely treatment is given. Hence, their safety is our responsibility.

This is a tribute to all the front-line workers working tirelessly during the uncertain pandemic.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Wong RL, Ting DS, Wan KH, Lai KH, Ko CN, Ruamviboonsuk P, et al. COVID-19: Ocular manifestations and the APAO prevention guidelines for ophthalmic practices. Asia Pac J Ophthalmol (Phila) 2020;9:281-4.  Back to cited text no. 1
    
2.
Londhe C, Londhey V. Health care workers in COVID-19: From lockdown to unlock and beyond! J Assoc Physicians India 2020;68:11-2.  Back to cited text no. 2
    
3.
Khanna RC, Honavar SG. All eyes on coronavirus – What do we need to know as ophthalmologists. Indian J Ophthalmol 2020;68:549-53.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Pandey SK, Sharma V. A tribute to frontline corona warriors – Doctors who sacrificed their life while saving patients during the ongoing COVID-19 pandemic. Indian J Ophthalmol 2020;68:939-42.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Demartini K, Konzen VM, Siqueira MO, Garcia G, Jorge MS, Batista JS, et al. Care for frontline health care workers in times of COVID-19. Rev Soc Bras Med Trop 2020;53:e20200358.  Back to cited text no. 5
    
6.
Wu P, Duan F, Luo C, Liu Q, Qu X, Liang L, et al. Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China. JAMA Ophthalmol 2020;138:575-8.  Back to cited text no. 6
    
7.
Hu K, Patel J, Swiston C. Ophthalmic manifestations of coronavirus (COVID-19). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. weblink: Treasure Island (FL): StatPearls Publishing; 2021 Jan-. [Internet]. [Last updated on 2021 Feb 26].  Back to cited text no. 7
    


    Figures

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    Tables

  [Table 1], [Table 2], [Table 3]



 

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