Analysis of ocular emergencies in a reference eye center in Brazil

The medical record database of the Fundação Altino Ventura, Recife, Brazil was retrospectively analyzed and included all patients assisted at the ophthalmic emergency room between January 2017 and January 2018. Medical records with incomplete data and outpatient complaints were excluded. For records with multiple visits, only the initial visit was considered.

Results:

In 1 year, 134,788 patients (mean age at admission: 38.7 ± 22 years; range: 0-99 years) were admitted at the emergency room of the Fundação Altino Ventura. The most frequent diagnoses were conjunctivitis (52,732 cases; 37.3%), blepharitis (7,213 cases; 5.1%), and corneal/conjunctival foreign body (6,925 cases; 4.9%). Corneal/conjunctival foreign body and ocular trauma had an eight- and two-fold higher incidence in male patients, respectively (both p<0.001). Female patients presented a two-fold higher incidence of trichiasis and blepharitis than males (p<0.001). Corneal/conjunctival foreign body and ocular trauma affected more patients in a productive age (>15 years), while corneal ulcers, blepharitis, and trichiasis affected more elderly patients. All diagnostic clusters (e.g., infectious diseases, ocular trauma, foreign bodies, retinopathies, eyelid disorders, corneal diseases, glaucomatous crisis, and neuroophthalmological diseases) were more common during the spring season (p<0.001).

Conclusion:

The most common ocular emergencies in the present study were infectious diseases and foreign body. However, the incidence of ophthalmological emergencies was influenced by the age and sex of patients, as well as the time of the year.

Keywords:
Emergency; Eye disease; Vision disorder; Conjunctivitis; Foreign body; Eye injury; Season; Brazil

Characteristics	Frequency
Sex
Male	69,917 (51.9%)
Female	64,871 (48.1%)
Residence
Pernambuco state	133,230 (98.8%)
Other state	1,558 (1.2%)
Age
≤10 years	18,125 (13.4%)
11-18 years	7,001 (5.2%)
19-42 years	52,651 (39.0%)
43-58 years	28,456 (21.1%)
59-82 years	26,211 (19.4%)
≥83 years	2,344 (1.7%)

Diagnosis	Frequency
Conjunctivitis	52,732 (37.3%)
Blepharitis	7,213 (5.1%)
Corneal foreign body	6,925 (4.9%)
Hordeolus	6,454 (4.7%)
Corneal ulcer	5,202 (3.8%)
Keratitis	3,388 (2.5%)
Eye trauma	3,096 (2.2%)
Corneal abrasion	3,054 (2.2%)
Trichiasis	2,044 (1.5%)
Subconjunctival hemorrhage	1,735 (1.2%)
Retinal detachment	1,303 (0.9%)

Diagnosis	Sex				p-value^* * Chi-squared test.
	Female		Male
	n	%	n	%
Conjunctivitis	26,564	59.8%	26,168	53.1%
Blepharitis	4,672	10.5%	2,541	5.2%
Hordeolus	3,478	7.8%	2,976	6.0%
Corneal ulcer	2,035	4.6%	3,167	6.4%
Keratitis	1,631	3.7%	1,759	3.6%
Trichiasis	1,446	3.3%	598	1.2%	<0.001
Corneal abrasion	1,202	2.7%	1,854	3.8%
Subconjunctival hemorrhage	1,019	2.3%	716	1.5%
Eye trauma	855	1.9%	2,241	4.5%
Corneal foreign body	707	1.6%	6,219	12.6%
Retinal detachment	522	1.2%	782	1.6%
Glaucomatous crisis	255	0.6%	266	0.5%

Diagnosis	Age group								p-value^* * Chi-squared test.
	≤20 years		21-59 years		60-80 years		>80 years
	n	%	n	%	n	%	n	%
Conjunctivitis	16,527	72.3	31,130	56	4,606	34.3	469	26
Blepharitis	492	2.2	3,771	6.8	2,534	18.5	416	23.1
Corneal foreign body	489	2.1	5,898	10.6	512	3.8	27	1.5
Retinal detachment	43	0.2	829	1.5	404	3.0	28	1.0	<0.001
Hordeolus	2,629	11.5	3,425	6.2	382	2.8	18	1.0
Eye trauma	894	3.9	1,836	3.3	324	2.4	42	2.3
Trichiasis	22	0.1	414	0.7	1,329	9.9	279	15.5
Corneal ulcer	378	1.7	3,039	5.5	1,490	11.1	295	16.4

Conselho Brasileiro de Oftalmologia Rua Casa do Ator, 1117 - cj.21, 04546-004 São Paulo SP Brazil, Tel: 55 11 - 3266-4000, Fax: 55 11- 3171-0953 - São Paulo - SP - Brazil
E-mail: abo@cbo.com.br

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[1] Corresponding author: Tiago de Assis Clemente de Araújo. E-mail: tiagodeassis.ca@gmail.com