Response to letter: COVID-19 and macular edema-a necessary blindness?

Dear Editor,

We certainly agree with Navel et al. that ophthalmologists have faced difficult decisions during the COVID-19 pandemic and that a delicate balance is needed to protect both lives and vision. In order to strike this balance, it is important that all decisions are made on a case-by-case basis, taking into account the local infection rate and individual risk for loss of visual acuity. We believe that strategies for managing patients with retinal disease during this uncertain time should focus on the following:

Minimizing the risk of exposure to COVID-19 for both the patient and healthcare staff

Simplifying anti-vascular endothelial growth factor treatment regimens

Prioritizing treatment for those at greatest risk of irreversible vision loss

By implementing stringent safety practices and triaging those who are most vulnerable, we have the opportunity to continue to provide the best possible care to patients.

With lockdown restrictions now easing in many countries, we are re-evaluating our initial guidance [1] to determine which measures can be relaxed while the infection rate remains low and which should remain in place until a suitable vaccine or treatment for COVID-19 becomes available. The updated guidance for the acute phase of the COVID-19 pandemic and for the post-lockdown era will be available from https://www.visionacademy.org/.