We read with interest your recent article ‘The impact of COVID policies on acute ophthalmology services–experiences from Moorfields Eye Hospital NHS Foundation Trust’ [1]. Interestingly you report reduced attendance with new retinal detachments (RD) compared with the same period last year. As you state, the reasons for such a decrease could be multiple. It would be interesting to know how much of the reduction, if any, represents declining out of area referrals in the face of social distancing and perceived travel restrictions. Your findings may reflect a sudden cessation in referrals from regions further afield. In Nottingham, we have undertaken a detailed analysis of our rhegmatogenous RD cases and would like to share our rational for undertaking such an analysis. Our findings are reported below.

The spread of coronavirus disease 2019 (COVID-19) has caused disruption to many aspects of life. Social distancing became the primary response to reduce infection. The slogan ‘stay home, protect the NHS, save lives’ became well recognised. The idea was simple: slow transmission to protect hospital capacity, preventing resource overload, maintaining effective healthcare systems with ventilator/staff availability. Routine surgery/outpatients were cancelled. Some ophthalmologists were redeployed. The direct impact of COVID-19 is clear, measured in terms of thousands of tragic deaths. Indirect consequences on public health are covert and yet to manifest.

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