Batson Sean, Kelly Katherine, Morrison David, Virgin Frank
a Tennessee Lions Eye Center at the Vanderbilt Eye Institute , Nashville , Tennessee.
b Vanderbilt University School of Medicine , Nashville , Tennessee.
J Binocul Vis Ocul Motil. 2019 Jul-Sep;69(3):126-130. doi: 10.1080/2576117X.2019.1625629. Epub 2019 Jun 17.
To review a single center experience with the diagnosis of visual impairment in patients with sensorineural hearing loss (SNHL) and propose a diagnostic algorithm. Retrospective study of patients with SNHL who were diagnosed with ophthalmologic abnormalities in the course of evaluation. University children's hospital and university-associated eye institute. Children with the diagnosis of sensorineural hearing loss aged 0-18 who received a formal ophthalmology examination between the dates of December 2000-December 2016 were included for analysis. Children were identified using ICD-9 and ICD-10 billing codes. Primary measures included diagnosis of SNHL, ophthalmologic diagnoses, and referral source. Two hundred and sixty-nine patients with SNHL met inclusion criteria. One hundred and thirty-one (48.5%) of these patients had an ophthalmic abnormality. When evaluating referral source, patients referred by a pediatrician following failed vision screen or visual complaint were more likely to have an ophthalmologic finding (61%, n = 147) when compared to referral by an otolaryngologist following diagnosis of SNHL (9.6%, n = 73). Seventeen of the 131 (13%) patients with at least one ophthalmic abnormality had an abnormality that was deemed unlikely to be detected by routine screening. Our study agreed with previously published works that there is a high rate of ophthalmic abnormalities in patients with SNHL. Evaluation of referral source for ophthalmology evaluation suggests that routine referral by otolaryngologists in patients with SNHL may not be an efficient means of identifying patients with treatable ophthalmic disease. Reliance on school and office screenings to detect ophthalmic abnormalities, prior to referral, is likely a more efficient model, even among patients with SNHL.
回顾单中心对感音神经性听力损失（SNHL）患者视力损害的诊断经验，并提出一种诊断算法。对在评估过程中被诊断为眼科异常的SNHL患者进行回顾性研究。研究地点为大学儿童医院和大学附属眼科研究所。纳入分析的患者为2000年12月至2016年12月期间接受正式眼科检查、年龄在0至18岁且诊断为感音神经性听力损失的儿童。通过ICD - 9和ICD - 10计费代码识别儿童。主要指标包括SNHL的诊断、眼科诊断和转诊来源。269例SNHL患者符合纳入标准。其中131例（48.5%）患者存在眼科异常。在评估转诊来源时，与听力损失诊断后由耳鼻喉科医生转诊的患者（9.6%，n = 73）相比，因视力筛查失败或视觉主诉由儿科医生转诊的患者更有可能有眼科检查结果（61%，n = 147）。131例至少有一项眼科异常的患者中有17例（13%）存在的异常被认为不太可能通过常规筛查发现。我们的研究与之前发表的研究结果一致，即SNHL患者的眼科异常发生率较高。对眼科评估转诊来源的评估表明，耳鼻喉科医生对SNHL患者进行常规转诊可能不是识别可治疗眼科疾病患者的有效方法。在转诊前依靠学校和办公室筛查来发现眼科异常，可能是一种更有效的模式，即使在SNHL患者中也是如此。
