many inflammatory neuro-ophthalmic disorders such as demyelinating diseases, myasthenia, and temporal arteritis are treated with various levels of immune suppression, and we must carefully examine the effects these treatments may have on morbidity and mortality related to COVID-19 and adjust our treatment algorithms accordingly.
COVID-19 poses particular risks of infection to health care providers, and this risk may be especially great for eye care providers, who sit face to face mere inches away from patients at the slit lamp. The ocular surface is believed to be a site of COVID-19 disease, and direct contact of viruscontaining droplets or aerosolized particles with mucous membranes, including the eye, is a suspected route of transmission (2) (3) (4) . In fact, one of the first physicians to raise concerns regarding the spread of a novel coronavirus was Dr. Li Wenliang, MD, an ophthalmologist, who later died of COVID-19 and was believed to have contracted the virus from an asymptomatic glaucoma patient in his clinic. In addition, risk of nosocomial spread of the disease must be minimized in all clinical settings. As a consequence, medical care in the era of COVID-19 has been profoundly altered, creating particular difficulties for the traditionally physical examination-based practice such as neuroophthalmology. We are also being challenged to innovate in the area of resident and fellow training during a pandemic. Many physicians have suffered financial losses. However, these challenges also create opportunities for innovation in virtual health and telemedicine in neuro-ophthalmology and for the use of smartphone and video technology. Online visual field testing, for example, has accelerated in heavily hit regions. It is to be hoped that in the future these technological advances can be levied to expand access to neuroophthalmology services, especially in underserved areas.
By engaging directly with both the challenges and innovations in the field of Neuro-ophthalmology in the era of COVID-19, we hope to showcase and promote the growth of our field in these particularly challenging times.