Changing Trends in Eye-Related Complaints Presenting to the Emergency Department in Beirut, Lebanon, over 15 Years

Abstract

Objective To report the 15-year trend in ophthalmic presentations to the emergency department (ED) at the only medical center in Lebanon that provides 24-hour ophthalmologic care. Methods Retrospective review of 1967 patients presenting to the ED with eye-related complaints between September 1997 and August 1998 and between September 2012 and August 2013. Diagnoses were classified into 4 categories according to the International Society of Ocular Trauma and include penetrating eye injuries, nonpenetrating eye trauma, nontraumatic ophthalmic emergencies, and nontraumatic, nonurgent ophthalmic conditions. Results One thousand sixty eye-related presentations out of 39,158 total ED visits (2.71%) presented in 1997 compared to 907 out of 46,363 in 2012 (1.96%). Penetrating and nonpenetrating eye emergencies decreased between 1997 and 2012 (7.17% to 4.19%, p = 0.003 and 52.64% to 29.00%, p < 0.001, resp.) while nonurgent cases increased from 30.19% to 53.47% (p < 0.001). 57% of patients were covered by third-party guarantors in 1997 versus 73% in 2012. Conclusion Our results demonstrate a significant increase in nonurgent cases in parallel with the proportion of third-party payers, an issue to be addressed by public health policies and proper resource allocation. A detailed nationwide review is needed to make solid recommendations for the management of ophthalmologic presentations in the ED.

Ocular emergencies presenting to an emergency department in Central Spain from 2013 to 2018

“…A considerable proportion of these patients could have been assessed at an ophthalmic outpatient clinic or by general practitioners. 24 Admission or referral to another doctor was more likely in patients aged above 65 years, mainly due to endophthalmitis after surgery or intraocular injection and cornea infections or due to comorbidities.…”

“…Improving patient education, enhancing general practitioner knowledge of ophthalmic care, and better assistance for patients in primary care services or in general EDs will ultimately allow more efficient delivery of appropriate care. 24 Also, there is a growing evidence base around the use of specific ophthalmic emergency triage tools which can be administered by the patient, 25 computer, 26 or health care professionals 27,28 and can be used to improve the efficiency of ED facilities.…”

Impact of Covid-19 pandemic on Ophthalmic Emergency Department in an Italian tertiary eye centre

“…In 2012, a systematic review reported that nearly 40% of all ED visits were for non-urgent conditions, 13 and more recently Channa et al 6 found a similar result in OED, with more than 40% of ophthalmic consultations being non-urgent. Nevertheless, OED urgency rates published by other groups are quite different from each other (21.5%, 14 35.8%, 15 50-70%, 16 over 30% 17 and 73% 18 ). In the COVID-free period, our urgency rate was 39.1%, with a 46.7% of non-urgent conditions.…”

Ophthalmology emergency department visits in a Brazilian tertiary hospital over the last 11 years: data analysis

“…The increase of 39.2% found in our analysis is higher compared to previous studies from other countries. A previous study compared the change in eye-related trends to their ED in Beirut, Lebanon, from 1997 to 2012, finding a less significant increase in the inflow of 39,158 to 46,363 (+ 18%) during a 15-years period (13) . Another similar study found an increase in the inflow of 11% from 2001 to 2014 based on data analysis from more than 11 million visits in the mentioned period in the United States (14) .…”