B Girard1, F Bourcier, I Agdabede, L Laroche. 1. Service d'ophtalmologie, hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 75020 Paris, France.
Abstract
PURPOSE: To investigate the numbers and characteristics of patients with ophthalmological emergencies presenting at a general hospital. METHODS: Retrospective analysis of ophthalmological emergencies over 11 years included comparison with demographic changes and, over the last 2 years, analysis of the patients treated (age, sex, and pathology, according to 23 preselected pathologies). Ophthalmological examinations were done by a senior ophthalmologist. RESULTS: The activity rose from 396 patients in 1989 to 2,793 in 2000. The prevalence of ophthalmological emergencies in the area was 5.1 per 1,000 residents. The ophthalmological emergency rate compared with all emergencies in a general hospital classified as an Emergency Department Hospital was 5%. The male to female ratio was 1.88, the excess being explained by the higher risk of injury in men (professional and domestic). Of these patients, 28% were under 18 years of age, 43% were between 18 and 40, and 29% were over 40 years old. Most patients were self-referred. Fifty-three percent of the patients were from the hospital's influence sector. Of all ophthalmic patients, 3%-5% were hospitalized, 65% for medical reasons and 35% for surgical and trauma reasons. We pre-listed 23 pathologies to screen our patients, which covered 95% of all the patients examined in the emergency department. These ophthalmological medical emergencies were classified as follows: 20% infections disease, 12.6% ocular inflammation, 0.8% neurophthalmology. Traumatology can be classified as follows: 6.4% ocular burns, 2% electrical arc injuries, 35.3% corneal lesion, 10% injuries of conjunctiva, sclera, corneosclera, lacrimal duct, and 1% perforation of the eyeball. CONCLUSION: There is a real need for ophthalmic emergency services in general hospitals. Benign pathologies not needing diagnosis and adapted treatment were not noted in our study. The cheapest and most efficient way to diagnose these ophthalmic emergencies appeared to be the ophthalmological emergency center with a senior ophthalmologist, according to the regional health organization.
PURPOSE: To investigate the numbers and characteristics of patients with ophthalmological emergencies presenting at a general hospital. METHODS: Retrospective analysis of ophthalmological emergencies over 11 years included comparison with demographic changes and, over the last 2 years, analysis of the patients treated (age, sex, and pathology, according to 23 preselected pathologies). Ophthalmological examinations were done by a senior ophthalmologist. RESULTS: The activity rose from 396 patients in 1989 to 2,793 in 2000. The prevalence of ophthalmological emergencies in the area was 5.1 per 1,000 residents. The ophthalmological emergency rate compared with all emergencies in a general hospital classified as an Emergency Department Hospital was 5%. The male to female ratio was 1.88, the excess being explained by the higher risk of injury in men (professional and domestic). Of these patients, 28% were under 18 years of age, 43% were between 18 and 40, and 29% were over 40 years old. Most patients were self-referred. Fifty-three percent of the patients were from the hospital's influence sector. Of all ophthalmic patients, 3%-5% were hospitalized, 65% for medical reasons and 35% for surgical and trauma reasons. We pre-listed 23 pathologies to screen our patients, which covered 95% of all the patients examined in the emergency department. These ophthalmological medical emergencies were classified as follows: 20% infections disease, 12.6% ocular inflammation, 0.8% neurophthalmology. Traumatology can be classified as follows: 6.4% ocular burns, 2% electrical arc injuries, 35.3% corneal lesion, 10% injuries of conjunctiva, sclera, corneosclera, lacrimal duct, and 1% perforation of the eyeball. CONCLUSION: There is a real need for ophthalmic emergency services in general hospitals. Benign pathologies not needing diagnosis and adapted treatment were not noted in our study. The cheapest and most efficient way to diagnose these ophthalmic emergencies appeared to be the ophthalmological emergency center with a senior ophthalmologist, according to the regional health organization.