Purpose:

The purpose of the study was to characterize emergency room (ER) ophthalmology referrals to identify the most common pathologies, the frequency of urgent and non-urgent diagnoses, and compare diagnostic accuracy between the ER physician and the ophthalmologist.

Methods:

Cross-sectional study, we included consecutive patients referred to the ophthalmology department from the ER of a large general teaching hospital in Bogotá, Colombia, from November 1, 2016, to April 30, 2017. Variables extracted from the patients’ medical records included age, sex, type of insurance, cause (traumatic vs. nontraumatic), referring physician’s diagnosis, final diagnosis, and urgency (urgent, semi-urgent, or non-urgent).

Results:

A total of 473 patients were included in this study. 52.9% of visits were for an urgent condition, 17.1% were considered semi-urgent, and 30% of the visits were not urgent. The most common diagnosis was a corneal foreign body (22.4%), often from a work-related accident. Urgent or semi-urgent visits and traumatic injuries were more frequent in males and in patients with job insurance (p < 0.01). The agreement between the diagnosis given by the ER physician and the ophthalmologist was 34.1%.

Conclusions:

A much higher prevalence of corneal foreign bodies (22.4%) was observed compared to the reported global literature, highlighting the urgent need to increase eye protection at work and home. About 30% of visits were due to non-urgent conditions, which could be decreased by teaching patients and training our nurses in triage to identify true ocular emergencies. ER physicians need more ophthalmology training evidenced by the low agreement between their diagnosis and the ophthalmologist’s diagnosis.

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