Wilmer Eye Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital (F.A.W.).
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (J.S.).
Am J Ophthalmol. 2023 Oct;254:36-43. doi: 10.1016/j.ajo.2023.03.016. Epub 2023 Mar 24.
To characterize the most common ophthalmic conditions seen in the emergency department (ED) DESIGN: Cross-sectional study METHODS: This is a multicenter study of 64,988 patients who visited the Bascom Palmer Eye Institute, Massachusetts Eye and Ear, Wills Eye Hospital, and Johns Hopkins Hospital/Wilmer Eye Institute from January 1, 2019, until December 31, 2019. Demographic and primary diagnosis data were extracted including gender, age, race, ethnicity, insurance type, and ophthalmology consult status. Descriptive statistics were performed on all data using STATA IC 14 (64-bit).
A total of 64,988 patients with primary ocular diagnoses were seen across all 4 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 conjunctivitis (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 of 5139, 44.4%) and primary open-angle glaucoma (382 of 1379, 27.7%) were the most frequently seen subtypes of conjunctivitis and glaucoma.
The most regularly treated ophthalmic conditions in high-volume EDs tend to be lower acuity diagnoses. To combat ED overcrowding and rising health care costs in the United States, we suggest diverting eye-related ED visits to a specialized eye ED service or same-day eye clinic appointment in addition to expanding education for patients and primary care clinicians.
描述急诊科（ED）常见的眼科疾病特征。
横断面研究。
这是一项多中心研究，共纳入 2019 年 1 月 1 日至 12 月 31 日期间在 Bascom Palmer 眼科研究所、马萨诸塞州眼耳医院、威尔斯眼医院和约翰霍普金斯医院/威尔默眼科研究所就诊的 64988 例患者。提取了人口统计学和主要诊断数据，包括性别、年龄、种族、民族、保险类型和眼科会诊情况。使用 STATA IC 14（64 位）对所有数据进行描述性统计。
在所有 4 个 ED 中，共观察到 64988 例具有原发性眼部诊断的患者。大多数患者为白人（63.1%）、非西班牙裔/拉丁裔（64.8%）和女性（52.3%）。最常见的年龄组为 50-64 岁（28.6%）。所有机构中最常见的诊断是结膜炎（7.91%）、角膜擦伤（5.61%）、干眼症（4.49%）、玻璃体后脱离（4.15%）、霰粒肿（3.71%）、角膜溃疡（3.01%）、结膜下出血（2.96%）、角膜异物（2.94%）、视网膜脱离（2.51%）和青光眼（2.12%）。具体而言，病毒性结膜炎（5139 例中的 2283 例，44.4%）和原发性开角型青光眼（1379 例中的 382 例，27.7%）是最常见的结膜炎和青光眼亚型。
在高容量 ED 中，最常治疗的眼科疾病往往是低视力诊断。为了缓解美国 ED 过度拥挤和医疗保健费用上升的问题，我们建议将与眼睛相关的 ED 就诊分流到专门的眼科 ED 服务或当天的眼科诊所预约，同时加强对患者和初级保健临床医生的教育。
