Ophthalmic consultations drop 35% during Covid-19 pandemic

Those who depend on the Unified Health System (SUS) to treat eye problems faced challenges in 2020. According to the Brazilian Council of Ophthalmology (CBO), the Covid-19 pandemic made it difficult to provide the service to the population.

The drop in attendances was sharp compared to 2019 numbers. The problem especially affected people who depend exclusively on the public network to have access to consultations and surgeries in the treatment of eye health.

According to information from the CBO, the most significant negative impact occurred in consultations with ophthalmologists. The retraction in volume in 2020 compared to 2019 reached 35%. The numbers of the Ambulatory Information System of the Unified Health System (SIA-SUS), analyzed with the support of 360° CI consultancy, show that, in absolute data, 3.7 million consultations were not carried out over the past year.
We have our query numbers

In 2019, 10.8 million procedures of this type were performed. The following year, the number dropped to 7.1 million, the biggest drop in absolute terms among all specialties available in the public network. The first two months after the decree of public calamity (April and May 2020) had the worst rates, with a reduction of 74% and 71%, respectively, in total procedures.

In these two months, in 2019, a total of 1.8 million consultations were carried out. In the same period, during the first year of the pandemic, 509 thousand were offered, that is, less than a third. This result has a direct consequence in the diagnosis and early treatment of eye diseases, such as glaucoma, cataract or diabetic retinopathy.

Number of consultations and ophthalmic surgeries drop in 2020. Covid-19 pandemic is identified as the main factor
Regions and States
Data from the CBO indicate that the pandemic negatively affected the performance of ophthalmological consultations in all regions of Brazil. However, in the comparison, the Center-West (-40%), Northeast (-38%) and Southeast (-35%) presented the biggest falls.

Among the states, the worst performances, when comparing the absolute numbers of 2020 with 2019, were in São Paulo (-1.7 million consultations), Minas Gerais (-441 thousand) and Rio de Janeiro (-406 thousand). In proportional terms, the problem most affected Acre (a drop of 64% in the number of consultations), Piauí (-57%) and Mato Grosso do Sul (-53%). Among the 27 units of the Federation, only Amapá appears with an increase of 33% in the performance of ophthalmological consultations, when compared to the years 2019 and 2020.

Recovery in 2021

Data from January to June 2021 suggest a trend of recovery in the volume of consultations, but the rates should not exceed the production of 2019, the last period in which the service was uneventful. Two years ago, in its first six months, 5.2 million ophthalmological consultations were registered in the public network. In the current year, in the same period, this total was 4.8 million.

For the CBO, the improvement in performance is a consequence of the advance in vaccination and the greater ease of access for patients to outpatient and hospital care units. In this process of resuming eye care, the survey shows that patients aged 60 to 64 years were the ones who most attended consultations in the first half of 2021, with 534,500 consultations. People between 60 and 74 years old represented 31% of the total consultations made, followed by the group of children under 1 year old occupying fourth place in the ophthalmologic offices, with a total of 412.1 thousand consultations in the analyzed period.

Surgeries

The radiography of ophthalmologic assistance in SUS also shows that Covid-19 affected eye surgery. In 2020, from January to December, almost 390,000 procedures of this type were performed less than in 2019. In total, there was a reduction of 27%.

In the same year, just over 1 million eye surgeries were performed. In 2019, 1.4 million were registered. When comparing the interval from March to December (the period in which the pandemic was under way), between 2019 and 2020, the CBO survey shows that 288,972 elective surgeries of the vision apparatus were no longer performed, indicating a drop of 46%.

In the assessment of the CBO, the protocols that restricted patients’ access to elective surgeries to expand the care infrastructure for people with Covid-19, as well as to reduce exposure to the virus within the units, contributed to this situation of fall.

Between January and July 2021, with the resumption of elective surgeries in hospitals, there was an improvement in the number of surgeries of the vision apparatus, but the scenario is still worrying. In this interval, 717.7 thousand procedures were registered, 29% higher than the 555.4 thousand in 2020, but still 13% lower than the 2019 data (829.5 thousand).

Northeast region has the lowest number of surgeries

The Northeast Region had the most significant percentage reduction, with 39% fewer surgeries in 2020, compared to the year 2019. Next are the Midwest (-34%), South (-33%) and Southeast (-22 %). The North suffered a deficit of only 1%.

The impacts also diverged in the states. Rondônia (-73%), Mato Grosso do Sul (-71%), Piauí (-57%) and Sergipe (-53%) presented the biggest percentage drops. In absolute terms, at the top of the ranking are São Paulo (-178 thousand surgeries), Rio de Janeiro (-54.5 thousand) and Pará (-53.9 thousand). Three units of the Federation had a positive behavior: Amapá, up 1,188%, Tocantins (74%) and Roraima (24%).

Luiz Oliveira is an intern at the Mentor Program and is under the supervision of the publisher Maria Eugênia

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