A comparison of eye problems in primary care and ophthalmology practices.

This study compares the most frequent presenting complaints and diagnoses of eye problems in primary care physician and ophthalmologist offices sampled by the 1985 National Ambulatory Medical Care Survey. The data show that primary care patients (seen by family/general physicians, internists, and pediatricians) with eye complaints constitute 2% of all patient visits and are predominantly for minor inflammatory (58%), traumatic conditions and foreign bodies (8.4%), visual disturbances (15.5%), and eyelid problems (3.9%). Conjunctivitis and corneal abrasion accounted for 54.4% of these diagnoses. Patients see ophthalmologists predominantly for vision problems (35.5%), eye exams (24.1%), and inflammatory conditions (24%). Refractive errors, cataracts, and glaucoma constituted 52.7% of ophthalmologist diagnoses. This study provides significant implications for curricular development. Medical schools, primary care residencies, and continuing medical education settings for primary care should emphasize in-depth knowledge of minor ocular inflammatory conditions, eye trauma, visual disturbances, and eyelid problems, as these areas encompass more than 85% of the eye problems seen by primary care physicians.