Epidemiology of Ocular Emergencies in a large Canadian Eye Center

Authors: Natalia M. Binczyk, Samir A. Nazarali, Karim Damji, Carlos Solar

Author Disclosures: N.M. Binczyk:  None.  S.A. Nazarali:  None.  K. Damji:  None.  C. Solarte:  None.

Abstract Body:  

Purpose: We aim to provide information on the epidemiology of eye emergencies in a large Canadian tertiary care centre. Assessment of the epidemiology of eye emergencies is essential to understanding patterns of disease and care delivery within a region. Identification of these patterns can inform decisions at the provincial and national level regarding resource allocation, public health initiatives, and educational requirements for health care providers. There is currently no literature on the epidemiology of ocular emergencies within a tertiary care centre in Canada.  

Study Design:  Prospective epidemiological study based on secondary use of patient data.  

Methods:  Patients seen in an emergency eye care centre between July 2020 and June 2021 were included in the study. The following were obtained from patient charts: patient demographics, referral details, final diagnoses, urgent imaging, emergency procedures, and further referrals. Data was analyzed by an epidemiologist on the study team using the Statistical Package for the Social Sciences (SPSS).  

Results:  2,586 patients were seen over the study period. Majority (58%) of the referrals were from emergency physicians. Optometrists and general physicians (GPs) contributed 14% and 11% of referrals, respectively. Majority of referral diagnoses were related to inflammation (32%), and trauma (22%). Most frequently preformed emergency procedures were corneal or conjunctival foreign body removal (39%) and corneal scraping (14%). 15% of emergency referrals came from rural locations. 4% of patients required emergency imaging within 24hours of presentation, most commonly CT head and orbits (66%) and X ray orbits (14%). Majority of the patients seen in the eye care centre were referred further to the outpatient stroke clinic (52%) and neurology (32%).  

Conclusions:  Emergency physicians, optometrists, and GPs might benefit most from continuing education in ophthalmology as they are most likely to encounter first presentations of ophthalmic emergencies. Public education targeting prevention of ocular trauma and infection, such as wearing eye protection while working and practicing good contact lens hygiene, would be beneficial. It’s essential that provinces have an efficient emergency referral and transport system, considering the vast Canadian landscape. Close working relationship with radiology and neurology is beneficial in large ophthalmic care centers to coordinate necessary care for patients.