Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care Center

Background. An ophthalmology consultation service is of significant benefit to patients in the hospital and is an instructive component of a residency education program. Ophthalmology consultations in a hospital present unique challenges to those seen in an outpatient clinic, for which the consultin...

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Main Authors: Daniel J. Oh, Levi N. Kanu, Judy L. Chen, Ahmad A. Aref, William F. Mieler, Peter W. MacIntosh
Format: Article
Language:English
Published: Hindawi Limited 2019-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2019/7807391
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spelling doaj-2a69a707c3ab48ac9634e961caeba44c2020-11-24T23:32:10ZengHindawi LimitedJournal of Ophthalmology2090-004X2090-00582019-01-01201910.1155/2019/78073917807391Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care CenterDaniel J. Oh0Levi N. Kanu1Judy L. Chen2Ahmad A. Aref3William F. Mieler4Peter W. MacIntosh5University of Illinois at Chicago, Department of Ophthalmology and Visual Sciences, Chicago, IL, USAUniversity of Illinois at Chicago, Department of Ophthalmology and Visual Sciences, Chicago, IL, USAUniversity of Illinois at Chicago, Department of Ophthalmology and Visual Sciences, Chicago, IL, USAUniversity of Illinois at Chicago, Department of Ophthalmology and Visual Sciences, Chicago, IL, USAUniversity of Illinois at Chicago, Department of Ophthalmology and Visual Sciences, Chicago, IL, USAUniversity of Illinois at Chicago, Department of Ophthalmology and Visual Sciences, Chicago, IL, USABackground. An ophthalmology consultation service is of significant benefit to patients in the hospital and is an instructive component of a residency education program. Ophthalmology consultations in a hospital present unique challenges to those seen in an outpatient clinic, for which the consulting ophthalmologist should be prepared. The purpose of this study was to profile the emergency room and inpatient ophthalmology consultations seen at an academic institution. Methods. A prospective study of 581 patients was conducted on inpatient and emergency room ophthalmology consultations at the University of Illinois at Chicago over twelve months. Characteristics such as the consulting service, type of and reason for consultation, subspecialty staffing service, diagnosis, and suitability for in-hospital evaluation were recorded. Results. Consultations were received from either inpatient wards (59.4%) or the Emergency Department (40.6%). The most common inpatient consulting services were internal medicine (22%), followed by neurosurgery (16%) and neurology (7%). All the consultations were categorized as acute (72.3%), chronic (6.0%), or screening (21.7%). Consultations categorized as screening included papilledema (31.0%), fungemia (20.6%), syndromic evaluation (19.8%), visual field evaluation (17.5%), and miscellaneous evaluation (11.1%). We classified the ophthalmic diagnoses into 63 unique diagnoses. Amongst the ophthalmic subspecialties, neuro-ophthalmologic diagnoses were the most common (32.0%), followed by retina (20.1%) and cornea (19.4%). Neuro-ophthalmology had the highest proportion of screening consultations (36.6%), while glaucoma had the least overall number of consultations (10.1%), and the least proportion of screening consultations (3.6%). A significant proportion of nonacute consultations (19.0%) was deemed to be more suitable for outpatient evaluation. Discussion. Consultation databases can be useful in preparing trainees for in-hospital clinical care. A wide range of ocular pathologies may present to the ophthalmology consultant, from acute trauma to screening for systemic syndromes. Some consultations may be more suitable for outpatient evaluation which may help optimize patient care.http://dx.doi.org/10.1155/2019/7807391
collection DOAJ
language English
format Article
sources DOAJ
author Daniel J. Oh
Levi N. Kanu
Judy L. Chen
Ahmad A. Aref
William F. Mieler
Peter W. MacIntosh
spellingShingle Daniel J. Oh
Levi N. Kanu
Judy L. Chen
Ahmad A. Aref
William F. Mieler
Peter W. MacIntosh
Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care Center
Journal of Ophthalmology
author_facet Daniel J. Oh
Levi N. Kanu
Judy L. Chen
Ahmad A. Aref
William F. Mieler
Peter W. MacIntosh
author_sort Daniel J. Oh
title Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care Center
title_short Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care Center
title_full Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care Center
title_fullStr Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care Center
title_full_unstemmed Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care Center
title_sort inpatient and emergency room ophthalmology consultations at a tertiary care center
publisher Hindawi Limited
series Journal of Ophthalmology
issn 2090-004X
2090-0058
publishDate 2019-01-01
description Background. An ophthalmology consultation service is of significant benefit to patients in the hospital and is an instructive component of a residency education program. Ophthalmology consultations in a hospital present unique challenges to those seen in an outpatient clinic, for which the consulting ophthalmologist should be prepared. The purpose of this study was to profile the emergency room and inpatient ophthalmology consultations seen at an academic institution. Methods. A prospective study of 581 patients was conducted on inpatient and emergency room ophthalmology consultations at the University of Illinois at Chicago over twelve months. Characteristics such as the consulting service, type of and reason for consultation, subspecialty staffing service, diagnosis, and suitability for in-hospital evaluation were recorded. Results. Consultations were received from either inpatient wards (59.4%) or the Emergency Department (40.6%). The most common inpatient consulting services were internal medicine (22%), followed by neurosurgery (16%) and neurology (7%). All the consultations were categorized as acute (72.3%), chronic (6.0%), or screening (21.7%). Consultations categorized as screening included papilledema (31.0%), fungemia (20.6%), syndromic evaluation (19.8%), visual field evaluation (17.5%), and miscellaneous evaluation (11.1%). We classified the ophthalmic diagnoses into 63 unique diagnoses. Amongst the ophthalmic subspecialties, neuro-ophthalmologic diagnoses were the most common (32.0%), followed by retina (20.1%) and cornea (19.4%). Neuro-ophthalmology had the highest proportion of screening consultations (36.6%), while glaucoma had the least overall number of consultations (10.1%), and the least proportion of screening consultations (3.6%). A significant proportion of nonacute consultations (19.0%) was deemed to be more suitable for outpatient evaluation. Discussion. Consultation databases can be useful in preparing trainees for in-hospital clinical care. A wide range of ocular pathologies may present to the ophthalmology consultant, from acute trauma to screening for systemic syndromes. Some consultations may be more suitable for outpatient evaluation which may help optimize patient care.
url http://dx.doi.org/10.1155/2019/7807391
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