Abstract
Purpose :
The purpose of this study was to investigate the acuity of all ophthalmology consults from the emergency department and inpatient ophthalmology consultations at a level 1 trauma center in Southern California.
Methods :
This was a retrospective chart review of patients evaluated by the ophthalmology consultation service at Loma Linda University Medical Center from June 2016 to May 2017. Age, gender, consulting service, reason for consult, diagnosis, and recommended follow up were recorded. The level of acuity of pre-consult was defined based on the reason for the consult and was stratified to three levels: acute, chronic, and screening exams. The post-consult acuity level was updated based on the result of the consult: emergent, acute, chronic, and other. Eleven diagnosis were labeled as emergent. Ophthalmology procedures and surgeries performed within 48 hours were recorded.
Results :
A total of 2043 charts were reviewed with an average of 170 new consults per month. Pre consult acuity included 69% acute consults, 4.3% chronic, and 25% screening exams. Post consult acuity included 24% emergent, 51% acute, 15% chronic, not urgent, or negative, and 10% were considered other. Of those with pre-consult acuity considered acute, 25% were updated to emergent after ophthalmologic exam with 30% requiring emergent surgery. Roughly 25% of all consults were screening exams, and of those two-thirds were negative screens or chronic diagnoses.
Conclusions :
Acuity stratification of reasons for ophthalmology consultation may be useful in designing guidelines for emergency department and inpatient ophthalmologic exams. Further studies at other medical centers are needed to customize such guidelines.
This is a 2021 ARVO Annual Meeting abstract.