Ocular Anterior Segment Pathology in the Emergency Department: A 5-Year Study
| Autor: | Bilawal Mahmood, Jennifer Y. Li, Angelique Mahavongtrakul, Jennifer J. Ling, Mustafa Safi, Ralph Kyrillos, Mark J. Mannis, Vincent Duong Tang |
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| Rok vydání: | 2020 |
| Předmět: |
Intraocular pressure
Pathology medicine.medical_specialty Visual acuity genetic structures Eye Diseases Vital signs Corneal abrasion 03 medical and health sciences 0302 clinical medicine Medicine Humans 030212 general & internal medicine Referral and Consultation Retrospective Studies business.industry Retrospective cohort study Emergency department corneal ulcer medicine.disease Triage eye diseases Ophthalmology 030221 ophthalmology & optometry sense organs medicine.symptom business Emergency Service Hospital |
| Zdroj: | Eyecontact lens. 47(4) |
| ISSN: | 1542-233X |
| Popis: | Introduction Patients with ocular complaints frequently present to emergency departments (EDs) for care. Emergency department practitioners are often the first to evaluate these patients and determine the next steps in their care, which can be a challenging task. The purpose of this study is to determine the frequency of anterior segment pathology in the setting of the ED in hopes that this information will be useful in creating more effective management algorithms. Methods A retrospective study based on electronic patient charts from the University of California Davis ED that included ophthalmology consults. We reviewed the charts for demographic data, as well as visual acuity (VA), intraocular pressure (IOP), and diagnosis as determined by ED and ophthalmology personnel, respectively. Results The most common anterior segment diagnoses were uveitis, corneal abrasion, corneal ulcer, meibomian gland dysfunction/dry eyes/blepharitis/punctate epithelial erosions, and conjunctivitis/epidemic keratoconjunctivitis. Emergency Department personnel measured the VA and IOP in 40.8% and 16.7% of patients, respectively. The ophthalmologist measured the VA and IOP in 78.4% and 95.1% of patients, respectively. The percentage agreement in VA measurement between ophthalmology and ED was 11.8%. The percentage agreement in IOP measurement between ophthalmology and ED was 0.86%. The percentage agreement in diagnosis between ophthalmology and ED was 49.4%. Conclusions Most ocular conditions that present in the ED are nonurgent and can be treated in an outpatient setting. However, ED personnel are often unable to obtain the proper "ocular vital signs" (the VA and IOP) and diagnoses. Our findings suggest a need for clear interprofessional discussion in creating an algorithm for triage and the management of eye conditions in the ED to deliver effective care. |
| Databáze: | OpenAIRE |
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