Comments on: Tool kit for survival: How to run and manage ophthalmic practices during the difficult time of COVID-19 crisis.

We would like to congratulate the Indian Journal of Ophthalmology (IJO) editorial team for publishing excellent and useful articles related to coronavirus disease (COVID-19) and ophthalmology practice. We would like to congratulate Dr. Honavar, Dr. Sachdev, Dr. Tamilarasan, Dr. Pandey, Dr. Sharma, and all authors for their excellent, informative articles on managing ophthalmic practices during the difficult time of COVID-19 crisis.[1234]

Most of the points regarding how to manage ophthalmic practices during and post-COVID-19 crisis have been highlighted and discussed by the above mentioned authors. One of the points we would like to lay stress upon is the psychological and mental health of the ophthalmologists post lockdown. As per a recent All India Ophthalmological Society (AIOS)-IJO survey on the psychosocial well-being of ophthalmologists and residents, moderately severe or severe depression was reported in about 20% of respondents. Ophthalmic postgraduate residents and fellows feel that this lockdown will have a major impact on their medical and surgical training. Many young ophthalmologists who have started their practice recently are suffering from clinical depression, anxiety, distress, and insomnia due to financial stresses. Many ophthalmic leaders and societies such as AIOS and American Academy of Ophthalmology are doing excellent work in reviving the ophthalmology practice guidelines to overcome the above challenges caused by the COVID-19 pandemic. Our workplaces should have stress management programs. Support mechanisms and stress-busters include mindfulness meditation exercises, physical exercise 2–3 times in a week, getting enough sleep, reading a book, listening to a podcast, trying out a new hobby (e.g. cook a new recipe, play an instrument, learn a language). Talking through our concerns, thoughts, and feelings with supportive friends and family can also help us in dealing with a stressful situation. Constantly reading, watching, or listening to upsetting media coverage about the COVID-19 crisis can unnecessarily intensify worry and agitation. We feel that it is important to take breaks from conversations regarding COVID-19 and talk about other topics to alleviate anxiety and distress.[156] Many health centers in India such as National Institute of Mental health and Neurosciences, Bengaluru (NIMHANS), Master Mind Foundation, Chennai, University of Mumbai are offering online as well as toll-free helpline support for psychological self-help intervention systems, including online web-based counseling format, online cognitive behavioral therapy for depression, anxiety, insomnia, and addictions.[7] In case of immediate psychological support, one can log on to the Aasra website and seek help or call their 24/7 helpline.[8] H.E.A.L (help, empathize, answer, listen) is a new initiative by the AIOS which is available for ophthalmologists for psychological support and care. In addition, several artificial intelligence programs have been put in use as interventions for the psychological crisis. The need of the hour is a show of solidarity by all AIOS members, mutually helping each other and guiding residents and young ophthalmologists to overcome these difficult times.

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