Cameron Oliver1, Carol Tadrous2, Gavin Docherty3, Simon Warner2. 1. University of British Columbia Southern Medical Program, Kelowna, B.C. 2. University of British Columbia Department of Ophthalmology and Visual Sciences, Vancouver, B.C. 3. University of British Columbia Department of Ophthalmology and Visual Sciences, Vancouver, B.C.. Electronic address: gavdoch@gmail.com.
Abstract
OBJECTIVE: This study was conducted to analyse data from emergency ophthalmology referrals after-hours from different hospitals to identify the most common pathologies and compare accuracy of diagnoses. The primary objective was to identify common presenting entities and common causes of misdiagnosis in the emergency department to help guide education initiatives. DESIGN: This was a retrospective chart review that looked at consults occurring between September 1, 2015, and October 21, 2016. METHODS: Emergency ophthalmology consults were reviewed and the date, time, age, sex, and provisional diagnosis were recorded. Ophthalmic diagnosis was compared with provisional diagnosis to compare agreement rate. Diagnoses were categorized to determine most frequent etiologies presenting on an emergent basis. RESULTS: A total of 697 consults were reviewed. The most common consults by diagnostic category were anterior segment (36.4%) and posterior segment (27.4%) pathologies. Together, these categories accounted for over 60% of all consults. Agreement between provisional diagnosis and final ophthalmology diagnosis was 65.8%. CONCLUSIONS: There was a reasonable agreement rate between referring services diagnosis and ophthalmology diagnosis. The retrospective nature of this study and use of categories to determine agreement are potential biases and the agreement rate may not reflect clinical practice. Most common diagnoses were similar to previous studies. The authors noted several diagnostic categories that could be targeted as areas for medical education to help increase recognition in the primary care setting and facilitate appropriate ophthalmic referral. Crown
OBJECTIVE: This study was conducted to analyse data from emergency ophthalmology referrals after-hours from different hospitals to identify the most common pathologies and compare accuracy of diagnoses. The primary objective was to identify common presenting entities and common causes of misdiagnosis in the emergency department to help guide education initiatives. DESIGN: This was a retrospective chart review that looked at consults occurring between September 1, 2015, and October 21, 2016. METHODS: Emergency ophthalmology consults were reviewed and the date, time, age, sex, and provisional diagnosis were recorded. Ophthalmic diagnosis was compared with provisional diagnosis to compare agreement rate. Diagnoses were categorized to determine most frequent etiologies presenting on an emergent basis. RESULTS: A total of 697 consults were reviewed. The most common consults by diagnostic category were anterior segment (36.4%) and posterior segment (27.4%) pathologies. Together, these categories accounted for over 60% of all consults. Agreement between provisional diagnosis and final ophthalmology diagnosis was 65.8%. CONCLUSIONS: There was a reasonable agreement rate between referring services diagnosis and ophthalmology diagnosis. The retrospective nature of this study and use of categories to determine agreement are potential biases and the agreement rate may not reflect clinical practice. Most common diagnoses were similar to previous studies. The authors noted several diagnostic categories that could be targeted as areas for medical education to help increase recognition in the primary care setting and facilitate appropriate ophthalmic referral. Crown
Authors: Amanda Schlenker; Carol Tadrous; Geoffrey Ching; Alfonso Iovieno; Nawaaz Nathoo; Tom Liu; Sonia N Yeung Journal: Can J Ophthalmol Date: 2021-03-05 Impact factor: 1.882