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Approximately 2-3 percent of emergency department (ED) visits are due to eye-related complaints, adding to the ED workload. Many of these could be seen instead by an optometrist who specializes in the examination, diagnosis and treatment of eye-related disorders. We sought to determine the proportion of ED patients with isolated eye-related complaints that could be managed by an optometrist.  Methods:  We performed an administrative database study and descriptive analysis of all patients presenting to Calgary EDs with eye-related complaints during a one-year period. We determined optometry eligibility by reviewing discharge diagnoses and assessing whether that condition was within the Alberta Association of Optometrys (AAO) defined scope of practice. Patients were considered ineligible if their condition was related to bites, stings, thermal burns, assault, MVA or operative complications; if they required hospitalization or referral to a non-eye specialist (e.g. neurology); if they had associated headache, dizziness, syncope, hypertension, neurologic abnormality (e.g. diplopia); if they had facial cellulitis, orbital infections, adverse drug effects, or if they underwent observation in the ED because of concerns about a cardiac or neurological condition.  Results:  In 2015, 7686 patients were seen in Calgarys 5 EDs with eye related complaints. Of these, 76.2% were optometry-eligible and 75% of optometry-eligible patients arrived during day or evening hours (0800-2100). The most common presenting complaints were visual disturbance (24.8%), redness (22.1%), and pain or photophobia (16.4%). Optometry-eligible patients waited an average of 110 min and had an ED LOS of 149 min.  Conclusion:  Approximately 3 in every 4 patients seen in the ED for eye related complaints could alternatively be seen by an optometrist. Further research is required to establish the feasibility of diversion to an optometrist from the ED for eye-related complaints.

cjem. canadian journal of emergency medical care/cjem

LO13: Eye care in the emergency department: what proportion of patients presenting to the emergency department with isolated eye related complaints could alternatively be seen by an optometrist?