Narrator: Coming up by Mayo Clinic Q&A,
Dr. Cheryl Khanna: Some people will go many, many years and
really not need much treatment at all for their ocular disease,
and other patients need intervention at an earlier stage
to avoid visual loss as permanent.
Narrator: And to help determine the best care for patients with
vision problems, Mayo Clinic's department of ophthalmology has
enlisted the help of artificial intelligence.
Dr. Cheryl Khanna: We can organize this data and develop
mathematical models that can say, okay, if you're this person
and you have this disease, at this stage, what's your risk
long term?
Dr. Sanj Kakar: Welcome, everyone to Mayo Clinic Q&A. I'm
Dr. Sanj Kakar. Over the past year, healthcare workers in all
specialties have had to take precautions to protect
themselves and their patients to prevent the spread of
Coronavirus. ophthalmology is a practice that typically requires
providers to get close to their patients to examine and treat
their eyes. So how have they managed during COVID-19? joining
us to discuss this today is Mayo Clinic ophthalmologists and
chair of the clinical practice. Dr. Cheryl Khanna. Dr. Khanna
welcome to the program.
Dr. Cheryl Khanna: Thank you. Nice to be here.
Dr. Sanj Kakar: So as we've talked about with the
coronavirus pandemic, and especially with ophthalmology,
and how close you get to your patients, how things changed in
the last year?
Dr. Cheryl Khanna: Well, it has been a year of change. And it's
been a year where we've learned how to focus on the delivery of
care, using different approaches. Thankfully, in
ophthalmology, we have continued to see patients in the clinic
and perform our ophthalmology surgeries. And we've we've
managed to do that throughout the entire course of the last
year, which is amazing. We've had great leadership that's
allowed us to do this. And I really think that Mayo is a
wonderful place to receive care and a safe place, given the work
of all of our teams.
Dr. Sanj Kakar: So as you said, in your practice, a lot of
patients, for example, need regular checkups, and maybe
maintenance injections. How were you able to pivot in terms of
the practice to see them and treat them safely? such that,
for example, that what their vision wasn't affected?
Dr. Cheryl Khanna: Yeah, it's an important question. So we
were able at the beginning of COVID, we develop teams of
providers, because we didn't want everyone to be ill at the
same time. And so we would rotate our teams into the clinic
and into the operating rooms, while the other providers would
provide care virtually. And in this way, we were able to keep,
you know, social distancing, and decrease the volumes of our
patients. As the year progressed, we worked up to our
regular volumes, both in the clinic and the operating room.
So dividing in teams really helped us keep everyone safe. We
learned how to keep both our our patients as well as our
employees safe that Mayo Clinic by using many different
techniques. So of course, we use masking of social distancing, we
also developed different shields that were created through our
own 3d modeling clinics, for all of our instruments and different
technologies that we use here in ophthalmology. And so that
really helped, you know, create an additional barrier between
ourselves and the patient to keep both of us safe. Sometimes
we would sit patients further back in the in the exam room, we
also allowed people to have limited visitors, although
currently two visitors are allowed at Mayo Clinic for the
exam rooms are fairly small. So if we can limit visitors in the
exam room, which we try to do that even today. So these are
some of the safety measures that we took, in addition, 85% of our
staff opted to have the COVID vaccine, which has definitely
increased the safety of our male environment.
Dr. Sanj Kakar: So, you mentioned about virtual
appointments, pre-pandemic, how were you using virtual
technology? And where are you at?
Dr. Cheryl Khanna: The difference is really night and
day. So virtual technology was used a little bit for patients
who were not able to reach us that were, you know, coming from
a long distance, or maybe we needed to have some guidance for
their local provider. So it was occasionally used, but really
now it's part of our daily practice. And so, you know, we
may have a face to face visit initially with someone and then
we may, you know, follow up with them in a few months virtually.
So, we've incorporated virtual appointments into many different
sub-specialties in ophthalmology, it's worked
really well. It's been very important to keep patients, for
example, patients with macular degeneration, safe where we can
do some screening we can develop a protocol for them to follow
but they don't need to see the provider maybe every single
visit and we can touch base virtually Or they can get their
testing or a procedure and then leave. So we're doing a
combination of in person and virtual visits. And I think
that's really helped to keep everyone safe.
Dr. Sanj Kakar: Well, as you as you've been saying, safety is
critical, and the Department of ophthalmology and Mayo Clinic
has done a wonderful job in doing that. But did you see
patients, for example, who are nervous at first to come in and
have a detrimental effect their vision?
Dr. Cheryl Khanna: That's a great question. I think, you
know, in the last year, everyone's been in a different
spot, you know, some, some people are really worried about
COVID, and other people really don't. And then we have patients
with many different risk characteristics. So some people
have other diseases that put them at a higher risk for
problems if they did contract COVID. So everyone's comfort
level was a little bit different. I think the main take
home message is that, you know, if you have decreased vision, if
you have an ocular disease, it is a safe thing to do to come to
Mayo Clinic and receive care. And if you postpone treatment,
there may be irreversible vision loss that you really don't want
to encounter. So, you know, follow up in the department of
ophthalmology, it's a safe place, we've made many, many
adjustments to keep both our patients and the providers safe.
And it's worked. I've worked throughout the pandemic, and I'm
one of most of us really, who have been safe, without
contracting any COVID, you know, for ourselves or our family. So
it is a safe place to receive care. And if you have an ocular
condition that needs attending to, I think you should really
come from appointment.
Dr. Sanj Kakar: So in terms of ocular diseases, we've learned,
for example, with COVID-19, other areas in the body that it
becomes susceptible and new diseases have been seen. Have
you seen that in ophthalmology?
Dr. Cheryl Khanna: You know, there are some manifestations of
COVID in terms of ocular disease, such as conjunctivitis,
where the eyes become red and such, but really, thankfully,
the COVID has not had much of an impact on ocular disease in
terms of directly affecting the eyes.
Dr. Sanj Kakar: Now aside for COVID-19, what else is new with
them department of ophthalmology that you'd like to share with us
today?
Dr. Cheryl Khanna: So it's an exciting time and the Department
of ophthalmology, we have a new chairperson, Dr. Sophie Bakri,
who's has amazing energy and expertise. We have a lot of
clinical trials going on, including things like gene
therapy trials for macular degeneration and retinal
dystrophies. We have we have other research involving
keratoconus, we're looking at minimally invasive glaucoma
procedures for patients with glaucoma. We have new cataract
technologies emerging where we address different desires of the
patient to see both near and far correct astigmatism just to name
a few things. So it's a very exciting time that apartment,
we're also learning how to use information that we've
accumulated over many years to predict which patients are at
higher risk for ocular disease. And we can, you know, triage
those patients appropriately.
Dr. Sanj Kakar: With a kind of that's what I wanted to ask you
about. I know you're a pioneer with artificial intelligence.
And so can you tell us a little bit about your interest in this
area and what you're hoping to try and achieve?
Dr. Cheryl Khanna: Absolutely. So we're very fortunate Mayo
Clinic that Dr. Farrugia has organized our data and Mayo
Clinic so we can really allow this to benefit our patients. So
we can use the knowledge that we've accumulated for decades.
And using artificial intelligence, or some people
call it deep learning. We can organize this data, develop
mathematical models that can say, Okay, if you're this
person, and you have this disease at this stage, what's
your risk long term? And do you need to be treated? You know,
with drops or laser or surgery? What is your risk over time? So
it really is about treating populations of patients
appropriately. Some people will go many, many years and really
not need much treatment at all for their ocular disease. And
other patients need intervention at an earlier stage to avoid
visual loss that's permanent. So it's about using information
that we've accumulated over many years in a very careful way at
Mayo Clinic to benefit our patients now and in the future.
So we're very excited about those new mathematical models
that we can use with our data.
Dr. Sanj Kakar: Oh, sure. Oh, that's that's fantastic. Is
there anything else that you want to share with us today that
we didn't touch upon?
Dr. Cheryl Khanna: I think I would just like to stress th
t Mayo is a very safe place o receive ophthalmology care. A
d don't hesitate to seek attenti n if you do have blurry vision
r you need ongoing treatment f r ocular disease. Because
e really don't want anyone o suffer from visual loss th
t could have been treate
Dr. Sanj Kakar: Thanks to Mayo Clinic ophthalmologist and chair
of the clinical practice Dr. Cheryl Khanna, for joining us
today. Thanks so much, Dr. Khanna,
Unknown: Thank you so much for having me.
Narrator: Mayo Clinic Q&A is a production of the Mayo Clinic
news network and is available wherever you get and subscribe
to your favorite podcasts. To see a list of all Mayo Clinic
podcasts, visit news network dot Mayo clinic.org. Then click on
podcasts. Thanks for listening and be well. We hope you'll
offer a review of this and other episodes when the option is
available. comments and questions can also be sent to
Mayo Clinic news network@mayo.edu