• Sarah Powell, Emer Doolan, Karen Curtin, Aoife Doyle, and Colm O'Brien.
• Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.
• Ir J Med Sci. 2022 Dec 1; 191 (6): 281328222813-2822.

BackgroundGlaucoma is the leading cause of irreversible blindness globally. During the COVID-19 pandemic, an enforced reduction in capacity resulted in the deferral of routine outpatient appointments for glaucoma patients.AimThis study analyses patient outcomes following the establishment of a drive-through intra-ocular pressure (IOP) clinic during the COVID-19 pandemic to alleviate increased pressure on the tertiary glaucoma services at Royal Victoria Eye and Ear Hospital (RVEEH) and Mater Misericordiae University Hospital (MMUH) between August 2020 and June 2021.MethodsA 1-lane driveway system was established in a marquee on the grounds of City West hotel. IOPs were measured in patients' cars using a hand held iCare100 tonometer. Results were reviewed by a consultant ophthalmologist. At hospital follow-up clinic visits, IOP was measured using the Goldmann applanation tonometer (GAT).ResultsThree hundred one patients of a total of 672 who attended the drive-through clinic have subsequently attended a designated hospital follow-up appointment. In this cohort, the mean drive-through iCare IOP of 19.4 mmHg ± 6.0 was significantly higher (< 0.005) than the mean GAT IOP at the pre-drive through clinic visit (16.3 mmHg ± 3.7) and the post drive-through hospital follow-up visit (17.2 mmHg ± 4.1). Two hundred twenty-six (75%) patients did not need any treatment change, 53 (18%) required eye drop medication changes, 10 (3%) underwent a laser procedure, 4(1%) required surgical intervention, and 8 (3%) were discharged. When patient outcomes were analysed according to IOP grade assigned at the drive-through clinic, those with an iCare IOP < 21 were significantly less likely to require a treatment change. The cohort with iCare IOP ≥ 30 were significantly more likely to have a laser or surgical intervention.ConclusionThe implementation of a drive-through IOP clinic was a safe and effective way to monitor glaucoma patients during COVID-19, and identify those at high risk of poor IOP control or requiring a change in treatment.© 2021. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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