Inside Ophthalmology

Lockdown limbo

From vaccines to definitions, life trundles on. Clare Quigley reports

Lockdown status: in my shoulder, I went back level 5. Government upstairs to the main operating movement theatres. There was one urgent restriction: 5km. case that needed to go ahead – a Hospital activities: tarsorrhaphy for a man admitted urgent or emergency care only. with a nasty Stenotrophomonas

Sprawled out on the carpet keratitis, who had a dangerously with Duplo and wooden blocks thinned cornea. It was a short scattered all around, Michael procedure for me to suture the and I were busy. I was occupied lids together, after excising a building an elaborate tower of thin strip off the surface of the blocks, and he was engrossed posterior lamella, with bolsters in pulling pieces of Lego apart, in place. holding aloft the shapes that he In January changeover liked most, exclaiming at them, happened, and I moved to and at 14 months old, chewing the cornea team. The theatre on them too. When my phone lists, which were previously rang out with the hospital’s filled with cataracts, grafts, number flashing up on screen, pterygiums and other anterior I was surprised. During my segment procedures, are empty free evening time – when I was now. Emergencies only. We not on call – why would they have to cut down the clinic be looking for me? numbers as much as possible “Hello?” “Clare?” It was Aideen, one of the ward managers. “The vaccine has arrived, we’re going to start vaccinating tomorrow. Do you want it?” “Yes please,” I sat up. Around this time Ireland Illustration by Eoin Coveney too. Some patients, though, still need to be seen. I work in a cornea clinic for the first time since my senior house officer years; I am a specialist registrar now, not so far from finishing training. After five years or so in ophthalmology, had the worst COVID numbers in Europe, recording a seven-day rolling average of That morning the jab was quick, almost painless. As synthetic messenger RNA rotating through different units and specialist clinics, I feel confident that I have seen 1,267 cases per million in early was being translated into COVID spike most common things. Day one January. This was after we had excellent numbers at 50 cases protein in my shoulder in clinic the Consultant Barry Quill asked me to look at a per million in early December. patient and describe what I saw. It seemed that as a nation we had relaxed and mixed too much “There is vascularisation of the cornea...” over the Christmas break. “What else? What level are those opacities at?” Mr Quill asked.

Getting vaccinated would be a relief. For my family, I am “Superficial stroma... With clear cornea in between.” The definitely the riskiest contact. My husband is working from home, patient sat patiently as I puzzled at her eye. not seeing people. Our child-minding system for Michael includes a I paused, unable to recall the eponym. shared nanny, a Brazilian woman who minds Michael together with “Salzmann’s,” Mr Quill said. his cousins in my brother’s house. I am careful at work, but I know I knew then that I would need to get back into my books. I that I am the most likely to get exposed, and go on to bring COVID had treated myself to the updated version of Kanski last year, home, and from there spread it on to my brother’s family and their but most of its pages still had that suspiciously fresh smell, two children. Getting vaccinated should reduce that risk by 95%, despite my aims to have re-read the whole thing by now. going by the Pfizer/BioNTech data. Studying while being a parent and working full time must be

Excited, even giddy, we waited for our shots the next day. The possible. Lockdown at least adds time for reading, if only I can cataract unit, a dedicated theatre to allow for a higher volume of manage to overcome ennui and focus. patients, had been repurposed as the vaccination centre for the At the end of the working day I cycle back home. Arriving hospital. That first day of vaccinating, there were about 60 doses at the small square we live on, I wave at the neighbours. They arriving. Not enough for everyone, so some doctors and nurses are another family of three; the father is a professional actor, would not get it straight away. People were anxious, enquiring who has acted in plays in Dublin’s national theatre, and in film. about their place on the priority list. Clerical and admin staff Ten months and counting for closure of his industry here. I am wanted it, and needed it, as their work takes them in and out of reminded that everyone faces their own problems, directly or the clinical areas of the hospital, but there were not enough doses indirectly, because of this virus. to cover everyone just yet.

That morning the jab was quick, almost painless. As synthetic Clare Quigley is a resident at the Royal Victoria Eye and Ear messenger RNA was being translated into COVID spike protein Hospital, Dublin, Ireland