Corneal and conjunctival injury seen in urgent care centres in Israel

Abstract

PurposeCorneal and conjunctival injuries (CCI) comprise a large portion of the cases presenting to hospital‐based emergency departments (ED) with ocular involvement. Urgent Care Centres (UCC) offer community based emergency care at lower cost than hospital‐based emergency departments (ED) and with greater temporal convenience than primary care office settings. While CCI prevalence and treatment at hospital‐based EDs has been well studied, this is the first report, to our knowledge, on CCI demographics and aetiology presenting to UCCs.MethodsThis retrospective study was approved by the institutional ethics committee. The setting is a UCC system in Israel, modelled on USA urgent care facilities, consisting of 17 branches at the time of the study. Electronic medical record data (between November 1, 2015 and October 31, 2016) of patients diagnosed with corneal disorder, foreign body or eye disorder were retrieved and reviewed for inclusion/exclusion criteria. Data collected included gender, age, chief complaint, diagnosis, treatment and discharge status (sent home or referred to ED). International Classification of Diseases, Ninth Revision (ICD‐9) codes were assigned to each record based on a review of all fields. UCC results were compared to all ED patients in Israel using data from a public report. Data were analysed by descriptive statistics and logistic regression analysis.ResultsOf the 602 074 charts screened, 4797 patients presented with CCI (0.8%). The average age was 32.6 ± 18.2 years and 71.3% were male. Among these, 26.4% were referred to the ED compared to 6.8% from the entire UCC cohort. ICD‐9 code Foreign body (FB) of the eye was the most common cause of CCI (56.5%) followed by the following ICD‐9 codes: trauma (18.1%), chemical in the eye (11.1%) and corneal disorder due to a contact lens (5.1%). Logistic regression analyses showed the following risk factors for ED referral: age (22–64), male gender, ICD‐9 code FB, work‐related injury and the presence of a clinical abrasion in the eye.ConclusionsThe aetiology of ocular injury at UCC is similar to previous studies of ED. Most CCI can be treated at UCC saving ED resources and underscores the importance of this mode of health care delivery in the overall health system.

Eye Injuries Epidemiology Description in a Working Population over 10 Years in Spain

“…The percentage of both injuries is higher than the percentage that Fea et al obtained in their 2008 study in an urgent care department in Torino, with 44.18% of the eye injuries classified as corneal damage and 10.03% as conjunctivitis [3]. Our results also show differences with the results of the recent study of Zimmerman et al in Israel [14]. Both studies were carried out in urgent care departments, so they studied the general population as well as workers.…”

“…In all risk factors analyzed (sex, age, and occupation), injuries with a higher number of cases and percentage were the keratitis and conjunctivitis incidences. The higher number of cases in males has been associated by some authors with a higher exposition due to the occupation they have [8,10,14,17,21]. In our study, males have a higher RR and had a higher percentage of keratitis incidences (p < 0.001), which comes from the damage of the cornea, which is the most exposed eye structure to risk factors associated with the occupation.…”

Preventing Ocular Surface Foreign Body Complications: Enhancing Awareness and Precaution

“…An ocular surface foreign body is an object such as glass, metal, or sand, which gets adhered to or embedded into different ocular surfaces 11 . These are commonly found in cornea and palpebral Conjunctival surfaces 12,13 .…”

Epidemiologic Evaluation and Clinical Aspects of Superficial Corneal Foreign Body Injuries at a Tertiary Referral Center in İstanbul

“…It has been stated that the use of PG can protect most of the workers from CFB trauma, as well as from possible scarring in the cornea (1). It has also been shown that leaving the CFB for more than 24 hours causes the rust ring to result in a corneal scar eventually (7).…”

“…Corneal foreign body (CFB) trauma is a common eye injury in the emergency departments (ED) (1). The CFB trauma is mostly associated with occupational accidents frequently seen in construction and metal industry workers (2).…”