Eye doctors seek to bring Waterloo Region’s backlog of surgeries back to pre-pandemic levels

KITCHENER — A regionalized approach to eye surgery that gives patients more choice is reducing wait times that doubled at the start of the pandemic.

While COVID-19 patients have been the primary concern during the pandemic, St. Mary’s General Hospital has prioritized eye surgeries to help ease some of the pressures on the profession.

Eye surgeries make up the bulk of the hospital’s current backlog, reporting in December that more than 5,000 of the 7,000 surgeries were specifically for eye care.

At Cambridge Memorial Hospital, more than half of the 2,000 surgeries in its backlog were for ophthalmologists.

The past two years have really had a “yo-yo” effect on the industry, said St. Mary’s ophthalmologist Chryssa McAlister, with various COVID-19 measures closing elective hospital surgeries, only to be reinstated and then closed again. .

When the first lockdown hit, ophthalmologists in the region were forced to look at all of their patients and reprioritize them based on those most in need. The patients were divided into four different categories, which ensured that when they returned to surgery, the most serious cases were treated first. Some wait times have reached up to two years.

“I think it helped because it ensured that the patients who were in the most pain waited as little as possible,” McAlister said.

But it hasn’t come without some growing pains, with ophthalmologists initially reported to be at one of the highest risks for COVID-19 in their practice, due to being close to their patients to perform eye exams. view.

It’s been a learning curve to keep everyone involved safe.

Prior to the rise of the Omicron variant, the ability was returning to pre-pandemic levels. Now new measures mean elective surgeries have been delayed again, adding to the thousands of patients already waiting for eye surgery.

While these numbers may seem large on paper, cataract surgery – which makes up the bulk of such surgeries – has often been in high demand, with long wait times even before the pandemic hit.

The surgery itself is relatively simple, taking only 20 minutes, with surgeons easily able to perform more than a dozen a day.

Age is the main risk factor for cataracts and, with the aging of the population, the demand is expected to continue to grow.

Over the past few years, the region — which includes Kitchener, Cambridge and Guelph — has worked to create a centralized referral database for cataract surgeries.

Once a patient is referred, they are shown the wait times for each of the 16 eye doctors, then asked if they want the fastest surgery, if they want to stay closer to home, or he wants to see a particular surgeon.

This allows patients to have advance information on wait times and choose the direction of their care, while working to equalize wait times in the region between individual ophthalmologists.

After years of working on the program, it officially went into effect last April and has helped alleviate some of the high patient volumes. St. Mary’s also opened an offsite surgery center in the past year to help reduce the backlog.

Locally, the average wait time for surgery in a pre-pandemic world was typically around a year, dropping to two years at the start of the pandemic. But with the various initiatives now in play, those wait times are similar to what they were before the pandemic began, McAlister said — his is currently around eight months after receiving a recommendation.

All eye doctors in the area perform cataract surgeries, but each will often have a specialty — McAlister focuses on pediatrics. She will often have one or two surgery days each week, a full procedure day in her office working with eye injections, lasers and minor in-office procedures, then two office days where she sees around 40 patients a day – morning for children and afternoons for adults.

Each week will often be different from the last, often based on patient priority.

When it comes to cataracts, surgery is often only performed once it begins to impact the patient – ​​the most common symptom is glare, difficulty reading fine print or driving at night, and simply the general lack of clarity of vision.

Whether a patient is currently on a waiting list or has postponed surgery, McAlister said anyone with eye problems should continue to try to get it treated as soon as possible.

There are many types of eye disease that can’t be identified without an optometrist or eye exam, she said, and you don’t want to risk delaying so much that it makes it worse.

And while most cataract patients can feel safe waiting for their surgery, it can be a frustrating experience, with some needing it more than others.

“Patients may experience blinding glare from headlights that makes them unsafe to drive even when meeting driving vision requirements,” she said.

“They are struggling to read or do their normal daily tasks, which is impacting their work and the activities they enjoy, and adding to that the stress of the pandemic and social isolation. Many cataract patients in Waterloo Region suffer while waiting for their surgery.

Emphasizing increased access to surgery, McAlister said she believes the region will be able to resolve the current backlog to return to a sustainable base barring further prolonged cancellations of elective surgeries.

“I think with the various initiatives we have put in place, we are well positioned to arrive at a more sustainable situation, while understanding that there will always be waiting times with the increasing number of patients,” she said.