Patterns of emergency department visits for disorders of the eye and ocular adnexa

Objective: To characterize the magnitude and patterns of visits to the emergency department (ED) for problems related to the eye and ocular adnexa. Methods: The National Hospital Ambulatory Medical Care Survey was used to obtain information on ED visits in the United Slates for conditions of the eye and ocular adnexa in 1993. Patients were identified by International Classification of Diseases, Ninth Revision, Clinical Modification, codes. National projections were based on a staged probability design. Results: There were 2.32 million projected ED visits for problems of the eye and ocular adnexa in 1993. Forty-nine percent of visits were for injuries, two thirds of which occurred in males. Thirty-five percent of injuries occurred in the home and 18% occurred in the workplace. Only 3% of patients required hospitalization. Most patients had private insurance; but substantial variations in coverage existed for patients who used the ED for injury- vs non-injury-related care. Conclusions: Emergency departments in the United States provide a large amount of eye care, much of which is for conditions other than trauma. Differences in insurance coverage for injury- and non-injury-related eye care indicate that factors other than medical urgency are involved in the decision to use ED services. Further studies are needed to determine the cost-effectiveness and quality of ocular-related ED visits.