Most Common Ophthalmic Diagnoses in Eye Emergency Departments: A Multicenter Study

Abstract

Purpose : We performed a cross-sectional, multicenter clinical study to characterize the most common ophthalmic conditions seen in the emergency department (ED).

Methods : 64,988 patients who visited the Bascom Palmer Eye Institute, Massachusetts Eye and Ear, Wills Eye Hospital, Johns Hopkins Hospital/Wilmer Eye Institute from January 1^st, 2019 until December 31^st, 2019 were included in the study. Demographic information and primary diagnoses were extracted from patient charts. Descriptive statistics were performed on all data using STATA IC 14 (64-bit). The main outcome measures were primary diagnosis, gender, age, race, ethnicity, insurance type, and ophthalmology consult status.

Results : A total of 64,988 patients with primary ocular diagnoses were seen across all four EDs. The majority of patients were White (63.1%), non-Hispanic/Latino (64.8%), and female (52.3%). The most frequently seen age group was 50-64 years (28.6%). The most common diagnoses across all institutions were conjunctivitides (7.91%), corneal abrasions (5.61%), dry eye (4.49%), posterior vitreous detachments (4.15%), chalazions (3.71%), corneal ulcers (3.01%), subconjunctival hemorrhages (2.96%), corneal foreign bodies (2.94%), retinal detachments (2.51%), and glaucoma (2.12%). Specifically, viral conjunctivitis (2283/5139, 44.4%) and primary open angle glaucoma (382/1379, 27.7%) were the most frequently seen subtypes of conjunctivitis and glaucoma.

Conclusions : This study offers a comprehensive report of the most widely presenting ophthalmic emergencies in four high volume EDs in the United States in 2019, including three eye-specific EDs. Importantly, our study shows that the top diagnoses in 2019 were largely those that are typically considered to be non-emergent. Enhanced education for patients and primary care clinicians and increased availability of urgent clinic appointments may combat ED overcrowding and rising health care costs in the U.S.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.