1 in 4 ER Visits for Eye Problems Aren't Emergencies
Pinkeye isn’t a medical emergency. Neither is a puffy eyelid. But a study done in February 2017 found that nearly one in four people who seek emergency care for eye problems have those mild conditions, and recommends ways to help those patients get the right level of care.
The national study, led by University of Michigan researchers, looked at nearly 377,000 eye-related emergency room visits by adults with private insurance over a 14-year period. The team has published its results in the journal Ophthalmology.
Nearly 86,500 of those visits were for three conditions that don’t ever need emergency treatment, 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.
The researchers then looked deeper at what drove inappropriate use of ER visits for conjunctivitis (pinkeye), blepharitis (swollen eyelids) and chalazion (eyelid bumps).
Younger people, men, those with lower incomes or dementia, and people of color were more likely to seek emergency care for these non-emergency conditions. 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 release quotes Brian Stagg, M.D., the study’s lead author and a clinical scholar at the U-M Institute for Healthcare Policy and Innovation, as saying “Depending on the eye condition, the emergency room is the right choice for some patients, but not the best place for many others,” says “Our findings suggest that eye-care professionals, insurers and emergency providers should work together to help people get the care they need for emerging eye issues, in the right setting.”
Stagg, an ophthalmologist, sees patients at the Kellogg Eye Center, which is part of Michigan Medicine, the U-M’s academic medical center. While U-M emergency patients have access to Kellogg specialist at all times, many ERs don’t, he notes.
A vision for avoiding inappropriate ER use
Stagg hopes the findings can be used by insurers and health providers to inform efforts to curb ER visits for issues that don’t need ER-level care.
This might include telemedicine appointments where eye specialists can examine patients remotely or get images sent to them digitally. Co-author Maria Woodward, M.D., another Kellogg ophthalmologist and IHPI member, has studied the potential for such options to work for people with diabetes, who have a higher risk of eye problems.
Other ways to reduce inappropriate emergency care for non-urgent eye issues might include incentives to primary care providers and eye specialists, to encourage more availability of after-hours appointments.