Ophthalmic emergencies in a district general hospital casualty department

Abstract

A survey of ophthalmic emergencies attending the casualty department of a district general hospital over a 12-month period is presented. The total number of new casualty attendances was 30,649 of which 1870 (6.1%) presented with an ophthalmic problem. There was a 3 to 1 male to female preponderance and a peak age of presentation between 20 and 30 years. The main aetiological factors were trauma 65.6% and inflammation 21.7%. Of the trauma patients 80% had sustained minor trauma (abrasions or foreign material to the cornea or conjunctiva) and of the patients with inflammation 71% had either conjunctivitis or blepharitis. There was a trend towards increased numbers in the summer months. The percentage of patients with inflammatory disease was higher in the early summer and the winter months. Nine of the 11 patients with acute angle closure glaucoma presented between November and February. All patients were initially seen by the accident and emergency medical staff, who were able to treat 69% without further consultation. No serious pathology was overlooked. It is suggested that, in the district general hospital setting, co-operation between the eye and the accident and emergency departments can be to their mutual benefit.