Bill Harvey: In-a-gadda-da-vida
Author: Yiannis Kotoulas
In anticipation of a few outdoor pre-Easter drinks with newly accessible family members this evening, I popped into the garden before work this morning to check on the status of the barbecue. I didn’t want to waste money on vegan sausages; they don’t grow on trees, you know. Or do they?
As if having waited for the opportunity, my 91-year-old neighbour (let’s call him Alan, as that is his name) appeared and asked me to cut back a large shrub near his back door. ‘I am so worried about walking into it that I haven’t been able to get out into the garden,’ he explained. Like many thousands, Alan had been due to have his cataracts removed last spring, but the surgery was postponed indefinitely after lockdown. What was then an inconvenience, the cataracts just enough to push him the wrong side of the driving requirement, are now clearly dense enough to seriously impact upon his life. We all need to remember the forthcoming tsunami of missed glaucoma/cataract/diabetes/macula appointment patients, support as we can, and keep abreast of new secondary care initiatives, such as the excellent Moorfields ‘cataract drive’ that started after the previous big lockdown and increased cataract extractions four-fold.
Coincidentally, a new US study has shown that ‘fear of SARS-CoV-2 exposure was associated with a roughly four-fold increase in the odds of patient loss to follow-up.’1 We can dispel this myth. We can also help those well-meaning folks like Alan to understand that, despite labels of ‘non-urgent,’ there may be times where even cataract needs some prioritisation. There needs to be a sensible balance between ‘life-threatening’ and ‘quality of life-threatening’ and this will be a dynamic balance.