[Rate of traumatic retinal injuries requiring urgent care. Is ocular fundus evaluation essential in the emergency room?].
BACKGROUND
A high rate of traumatic retinal injuries does not require a directed ocular fundus evaluation but those that deserve urgent care need it. The rate of traumatic retinal injuries that require urgent care was identified in order to learn whether there is a need of evaluating the ocular fundus in an emergency room.


METHODS
Patients with ocular trauma and ocular fundus evaluation who were referred to an Ophthalmology Service of a general hospital were included; patients with superficial foreign bodies were excluded. The rate of injuries that require urgent care (retinal detachment, intraocular foreign body) was identified and 95% confidence intervals (CI) were calculated.


RESULTS
One hundred fifty-three eyes of 148 patients (age 3-74 years, mean 26.4 years) were examined. Of 75 retinal injuries, 7 required urgent care (4.6%, 95% CI 1.3-7.9); the rate was 0.8% in closed globe trauma (95% CI 0-2.37) and 20.7 in open globe trauma (95% CI 5.9-35.5).


CONCLUSIONS
According to the rate of retinal injuries that would require urgent care in similar groups, in closed-globe trauma ocular fundus evaluation in the Emergency Room could be substituted by the evaluation of the fundus reflex; findings of any of these injuries in open-globe trauma does not modify the initial approach.
Lima-Gómez
Virgilio
V
Servicio de Oftalmología, Hospital Juárez de México. vlimag@prodigy.net.mx
Barrera-Fournier
Lizette Verónica
LV
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services; D005129:Eye Foreign Bodies / Q000175:diagnosis; D005131:Eye Injuries / Q000175:diagnosis*; D015807:Eye Injuries, Penetrating / Q000175:diagnosis; D005654:Fundus Oculi; D006801:Humans; D008875:Middle Aged; D009887:Ophthalmoscopy; D012160:Retina / Q000293:injuries*; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000209:etiology