Ophthalmic referrals from emergency wards-a study of cases referred for urgent eye care (The R.E.S.C.U.E Study).
OBJECTIVE
To characterize emergency department (ED) referrals in order to identify the most common pathologies, compare accuracy of diagnosis, and measure correlation of visual acuity (VA) and intraocular pressure (IOP) measurements between the ED and ophthalmology setting.


METHODS
Retrospective chart review of consecutive patients referred for an ocular emergency after hours to a tertiary care emergency eye clinic in Hamilton, Ontario, between February 17, 2015, and May 3, 2015 (n = 288).


METHODS
Variables extracted from the patients' charts included date of referral, age, sex, eye(s) under examination, VA at the time of referral, IOP at the time of the referral, site of referral, the referring physician's provisional diagnosis, VA at the time of the ophthalmologist consultation, IOP at the time of the ophthalmologist consultation, number of days between referral and ophthalmic consultation, and the ophthalmologist's diagnosis.


RESULTS
Agreement between ED provisional diagnosis and ophthalmology was good at 79.4% when classified according to anatomic location of pathology. A strong correlation was found between VA measurements in the ED and ophthalmology setting (p < 0.001). IOP measurement was infrequently checked in ED and a significant difference existed between ER physician and ophthalmologist measurements (p = 0.010) where ophthalmology reported lower IOP.


CONCLUSIONS
The 5 highest volume diagnoses in descending order were posterior vitreous detachment/vitreous syneresis, corneal abrasion, keratitis, anterior uveitis, and retinal tear/detachment. Visual acuity measurements in ED are reliable. IOP is infrequently checked in the ED and more unreliable when measured over 20 mm Hg.
Department of Ophthalmology, McMaster University, Hamilton, Ont. Electronic address: manreet.aalngh@medportal.ca.
Manreet
M
Alangh
Department of Eye Medicine & Surgery, Hamilton Regional Eye Institute, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, Ont; Ophthalmology and Vitreoretinal Surgery, Hamilton, Ont.
Varun
V
Chaudhary
Department of Ophthalmology, McMaster University, Hamilton, Ont.
Christopher
C
McLaughlin
Department of Ophthalmology, McMaster University, Hamilton, Ont.
Brian
B
Chan
Department of Ophthalmology, McMaster University, Hamilton, Ont.
Sarah J
SJ
Mullen
Hamilton Regional Eye Institute, Hamilton, Ont.
Joshua
J
Barbosa
D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005128:Eye Diseases / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D009885:Ophthalmology / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014792:Visual Acuity