Shapiro Jeremy N, Abuzaitoun Rebhi O, Pan Yue, Woodward Maria A, Clauw Daniel J, Lee Paul P, Shtein Roni M, De Lott Lindsey B
Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor.
Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor.
JAMA Ophthalmol. 2024 Jul 1;142(7):655-660. doi: 10.1001/jamaophthalmol.2024.1808.
National estimates regarding the frequency of presentations and patterns of care for eye pain are unknown. This information could guide research and clinical efforts to optimize outcomes.
To estimate eye pain visits in the US in the outpatient and emergency department (ED) settings.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cross-sectional study of National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey data (2008-2019) analyzed a population-based sample of visits to outpatient clinics and EDs. The sample consisted of patients presenting with eye pain. Data were analyzed from September 2023 to April 2024.
Weighted sample data estimated outpatient and ED eye pain presentations including patient and clinician characteristics, diagnoses (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10]), and disposition.
From 2008 through 2019, 4.6 million (95% CI, 3.9 million to 5.3 million) outpatient and 1.0 million (95% CI, 0.8 million to 1.1 million) ED eye pain visits occurred annually. Patients were predominantly women (63.2% [95% CI, 59.4%-67.0%]) and older than 60 years (46.6% [95% CI, 42.4%-51.0%]) in the outpatient setting. Patients presenting to the ED were more often men (51.8% [95% CI, 48.7%-55.0%]) and aged younger than 45 years (aged <15 years: 16.4% [95% CI, 13.9%-18.8%]; 15-24 years: 19.2% [95% CI, 16.6%-21.7%]; and 25-44 years: 35.6% [95% CI, 32.7%-38.5%]). In nearly half of outpatient eye pain visits, the major problem was classified as nonacute (2.0 million [95% CI, 1.6 million to 2.3 million]). Eye pain was the primary reason for the visit (RFV) in 42.0% (95% CI, 37.8%-46.2%) of outpatient visits and 66.9% (95% CI, 62.9%-70.9%) of ED eye pain visits. It was the only RFV in 18.3% (95% CI, 15.0%-21.7%) of outpatient and 32.7% (95% CI, 29.0%-36.4%) of ED eye pain encounters. Ophthalmologists evaluated the largest number of outpatient visits (45.3% [95% CI, 38.8%-51.7%). The primary diagnosis was non-vision threatening for most outpatient (78.5% [95% CI, 56.8%-100%]) and ED (69.9% [95% CI, 62.1%-77.7%]) visits when eye pain was the primary RFV. Additional follow-up was scheduled in 89.4% (95% CI, 86.2%-92.6%) of visits.
More than 5 million eye pain visits occur annually; the largest percentage are outpatient with ophthalmologists. Most diagnoses were non-vision threatening in both the outpatient and ED setting and resulted in additional care. Expanding therapeutic approaches to treat the causes of eye pain may reduce the burden on the health care system and optimize outcomes.
目前尚无关于眼部疼痛就诊频率和护理模式的全国性估计数据。这些信息可为优化治疗结果的研究和临床工作提供指导。
估计美国门诊和急诊科（ED）环境中眼部疼痛就诊情况。
设计、设置和参与者：这项对国家门诊医疗调查和国家医院门诊医疗调查数据（2008 - 2019年）的回顾性横断面研究分析了基于人群的门诊诊所和急诊科就诊样本。样本包括出现眼部疼痛的患者。数据于2023年9月至2024年4月进行分析。
加权样本数据估计了门诊和急诊科眼部疼痛就诊情况，包括患者和临床医生特征、诊断（《疾病和相关健康问题国际统计分类》第十次修订版[ICD - 10]）以及处置情况。
2008年至2019年期间，每年有460万（95%置信区间，390万至530万）次门诊眼部疼痛就诊和100万（95%置信区间，80万至110万）次急诊科眼部疼痛就诊。门诊患者中女性占主导（63.2%[95%置信区间，59.4% - 67.0%]），年龄超过60岁的占46.6%（95%置信区间，42.4% - 51.0%）。到急诊科就诊的患者男性更多（51.8%[95%置信区间, 48.7% - 55.0%]），年龄小于45岁（小于15岁：16.4%[95%置信区间，13.9% - 18.8%]；15 - 24岁：19.2%[95%置信区间，16.6% - 21.7%]；25 - 44岁：35.6%[95%置信区间，32.7% - 38.5%]）。在近一半的门诊眼部疼痛就诊中，主要问题被归类为非急性（200万[95%置信区间，160万至230万]）。眼部疼痛是42.0%（95%置信区间，37.8% - 46.2%）的门诊就诊和66.9%（95%置信区间，62.9% - 70.9%）的急诊科眼部疼痛就诊的主要就诊原因（RFV）。在18.3%（95%置信区间，15.0% - 21.7%）的门诊和32.7%（95%置信区间，29.0% - 36.4%）的急诊科眼部疼痛就诊中，它是唯一的RFV。眼科医生评估的门诊就诊数量最多（45.3%[95%置信区间，38.8% - 51.7%]）。当眼部疼痛是主要RFV时，大多数门诊（78.5%[95%置信区间，56.8% - 100%]）和急诊科（69.9%[95%置信区间，62.1% -
