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Negative impact of COVID-19 lockdown on papilloedema and idiopathic intracranial hypertension
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  • Published on:
    Supporting IIH patients through the COVID-19 pandemic
    • Sui H Wong, Consultant Neurologist & Neuro-ophthalmologist Guys & St Thomas' NHSFT; Moorfields Eye Hospital NHSFT

    Professor Sinclair and her team1 in Birmingham highlight an urgent issue affecting patients with IIH during the COVID19 pandemic. Their paper elegantly shows that weight gain worsens the severity of papilloedema and puts patients at risk of blindness. They also highlight the risk of worsening papilloedema not picked up with reduced access to hospital appointments.

    Here, we report the audit results from our service and share practical actions that have been effective for our service, with wider applicability.

    From May – Dec 2020, 58/102 (57%) IIH patients seen for follow up had gained weight compared to weight measured prior to pandemic by median 5.35 (range 0.6,27.3; SD 4.42)kg; with overall weight change of median 1.65 (range -24, 27.3; SD 6.81)kg for the group. 3/58 (5%) patients who gained weight, developed worsening papilloedema.

    We agree with the importance of optic disc examination as highlighted by Sinclair and colleagues1, and the need for PPE precautions in the COVID19 pandemic setting. An option we found helpful is fundus photography of the optic disc in the community which the patient then emails their clinician. Fundus photography is now widely available at high-street optometrists. Benefits of doing this include: circumventing patients’ fears of attending hospitals during the pandemic; a patient-held record for future comparison; and the option for clinicians to obtain a colleague’s second opinion on the optic disc photograph.


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    Conflict of Interest:
    None declared.