Study: Many Trips to ER for Eye Issues That Are Not Actual Emergencies

FEBRUARY 21, 2017

Many people who seek emergency care for eye problems actually have mild conditions, according to a study published in the journal Ophthalmology.

The national study, led by University of Michigan researchers, looked at nearly 377,000 eye-related emergency room (ER) visits by adults with private insurance over a 14-year period.  Nearly 86,500 of the ER visits were for 3 conditions that don’t ever need emergency treatment: conjunctivitis, blepharitis, and chalazion, and cost much more to treat in an emergency setting while also adding to ER crowding. Only about 25,300 were for clear eye emergencies. The rest were somewhere in the middle, according to the data.

Younger people, men, those with lower incomes or dementia, and people of color were more likely to seek emergency care for non-emergency conditions, teh researchers said. So were people who were “frequent flyers” in the emergency room, seeking ER care four times a year or more for non-eye problems.

On the other hand, those who had been seeing an eye specialist – optometrist or ophthalmologist – on a regular basis before their eye-related ER visit were much less likely to seek emergency care for a non-urgent eye problem.

The researchers discussed ways to reduce inappropriate emergency care for non-urgent eye issues, including possible incentives to primary care providers and eye specialists, to encourage more availability of after-hours appointments.

Adding insurance coverage for regular eye exams for those who wear contacts or eyeglasses, so that they develop a connection to a regular eye provider they can consult when symptoms develop, might also cut down on inappropriate ER use, the researchers said.

Their analysis reveals a 30% rise in all eye-related emergency visits during the study period, especially after 2011. Nearly all of this rise came in visits that they couldn’t classify as clearly urgent or clearly non-urgent. The researchers said they believe it may be linked to the increase in younger adults covered under their parents’ job-based insurance plans, allowed under the ACA since 2010. But they can’t fully determine the case from their analysis, and intend to explore the rise further.

Reference: 
Stagg BC, Shah MM, Talwar N, et al. Factors Affecting Visits to the Emergency Department for Urgent and Nonurgent Ocular Conditions.Ophthalmology. 2017; http://dx.doi.org/10.1016/j.ophtha.2016.12.039.



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