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Kimberly M Chan, Charles Gregory Maddux, Michael Rauser; The Inland Empire Eye Emergency Epidemiology Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3053.
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© 2017 Association for Research in Vision and Ophthalmology.
Access to ruptured globe repair in the Inland Empire (IE), which contains the counties of San Bernardino and Riverside in Southern California, is unclear. We tested the hypothesis that the high ruptured globe repair volume at Loma Linda University (LLU) is due to the lack of ophthalmologic coverage and/or resources in many hospitals in the IE.
Survey of hospitals in the IE via email or phone interview, collected by one individual, and analysis of residence of patients with ruptured globe repair at LLU from 01/01/2010 to 10/21/15.
37 ERs were surveyed, with a 83.8% response rate,16% percent via email survey, and 84% via phone. All of the trauma centers surveyed (16.2% of all the hospitals) had ophthalmology coverage. Ophthalmology coverage was reported in some form in 51.6% of the ERs surveyed: 68.8% had 24 hour/7 days (24/7) a week coverage, 18.8% had coverage only during business hours, and 12.5% had “other” coverage (which included only intermittent coverage). Of the ERs that had ophthalmology coverage, 81.3% reported having surgical privileges. Although 94% of the hospitals that had ophthalmologists with surgical privileges had operating microscopes, only 38.4% of these hospitals repaired ruptured globes. 13 hospitals were located outside of a 20 miles radius from a hospital that repaired ruptured globes; none of these hospitals had 24/7 ophthalmology coverage. 277 ruptured globes were repaired at LLU over approximately 5 years. The majority, 83.4%,of these cases (231) were from patients who lived in either San Bernardino or Riverside county. Analysis of these 231 cases demonstrated the following: 13.4% were less than 10 miles from our hospital, 27.3% were greater than 10 miles, 20.8% were greater than 20 miles, and 38.5% were greater than 30 miles from our hospital.
Location options for the emergency repair of ruptured globes in the Inland Empire are limited. Geographic coverage for this procedure could be improved if more ophthalmologists performed this procedure at ER facilities currently equipped for eye surgery.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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