The Impact of COVID-19 Pandemic on Practice Patterns and Psychological Status of Ophthalmologists in Turkey

Aim: To investigate the changes in ophthalmologists' working conditions and mental health status in Turkey during the first wave of the COVID-19 outbreak and reveal the relevant individual and workplace-related factors. Methods: This cross-sectional, nationwide, the survey-based study collected data between June and September 2020. Demographic characteristics, working conditions, precautionary measures in the workplace, and participants' Depression Anxiety Stress Scale (DASS-21) and Insomnia Severity Index (ISI) ratings were investigated. Results: This study included 360 actively working ophthalmologists. While 64% of them worked in the pandemic hospitals, 44% were actively involved in COVID-related departments. Among those, 56 (35%) declared that they had all personal protective equipment in sufficient quantity in their COVID department. Despite the restrictions, 32% reported continuing to see 25 to 50 patients per day in ophthalmology clinics, with the most common complaint being the ocular "itching and burning" sensation. 53% stated that they did not perform any surgeries. Symptoms of depression, anxiety, stress and insomnia were present in 65%, 56.9%, and 43% and 46.9% of participants, respectively. All DASS-21 subscales and ISI scores were found to be significantly higher during the pandemic. Female gender, older age, and lower satisfaction levels of hygiene conditions in COVID clinics were independent predictors of higher DASS-21 subscale scores in multivariate analysis. Being a resident was a major predictor of depression. Ophthalmologists working in a pandemic hospital were more likely to experience insomnia. Conclusion: Ophthalmologists have actively worked in COVID departments during the pandemic. Increased psychological distress among ophthalmologists compared to the pre-pandemic period is caused by personal factors and many determinants related to the workplace and practice patterns. Therefore, decreasing the transmission risk by creating a protective workplace and developing psychological support policies should be considered to minimize adverse psychological effects.