LAUSR

At the time of writing this article, the COVID-19 pandemic is severely disrupting the care of patients with choroidal melanoma in Britain and elsewhere. Vast numbers of individuals are developing severe illness with thousands of fatalities.1 Many ophthalmic workers have died (such as Li Wenliang) or are absent from duty because of illness or isolation. Others are redeployed at COVID-19 units. Patients are avoiding medical care, because they are afraid of catching coronavirus. Routine community optometry has largely been suspended. Non-urgent hospital clinic appointments are being deferred, as are surgical procedures, laser sessions and intravitreal injections of antiangiogenic agents. This lull will inevitably be followed by a surge of referrals and a backlog of patients needing assessment and treatment. Patients with choroidal melanoma will present with more advanced disease with lost opportunities for conserving vision and the eye in some cases.2 There will inevitably be deaths from metastatic disease, undoubtedly stirring concerns about whether any fatalities might have been prevented if the COVID-19 epidemic had not delayed treatment.3 The immediate crisis is expected to be followed by long-term national and personal financial difficulties, which will diminish healthcare resources and which will make it unaffordable for many patients to attend hospital clinics, especially if these are located far from their home. COVID-19 may permanently disrupt healthcare if it causes perennial epidemics, like influenza. These constraints demand drastic improvements in clinical practice to avoid unnecessary costs for patients and to conserve healthcare resources while maintaining quality of care after the COVID-19 …