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Multicenter Study
. 2024 Jul 1;142(7):655-660.
doi: 10.1001/jamaophthalmol.2024.1808.

Health Care Use for Eye Pain

Jeremy N Shapiro  1 , Rebhi O Abuzaitoun  1 , Yue Pan  1 , Maria A Woodward  1 , Daniel J Clauw  2 , Paul P Lee  1 , Roni M Shtein  1 , Lindsey B De Lott  1
Affiliations
Multicenter Study

Health Care Use for Eye Pain

Jeremy N Shapiro et al. JAMA Ophthalmol. .

Abstract

Importance: National estimates regarding the frequency of presentations and patterns of care for eye pain are unknown. This information could guide research and clinical efforts to optimize outcomes.

Objective: To estimate eye pain visits in the US in the outpatient and emergency department (ED) settings.

Design, setting, and participants: This retrospective cross-sectional study of National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey data (2008-2019) analyzed a population-based sample of visits to outpatient clinics and EDs. The sample consisted of patients presenting with eye pain. Data were analyzed from September 2023 to April 2024.

Main outcomes and measures: Weighted sample data estimated outpatient and ED eye pain presentations including patient and clinician characteristics, diagnoses (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10]), and disposition.

Results: From 2008 through 2019, 4.6 million (95% CI, 3.9 million to 5.3 million) outpatient and 1.0 million (95% CI, 0.8 million to 1.1 million) ED eye pain visits occurred annually. Patients were predominantly women (63.2% [95% CI, 59.4%-67.0%]) and older than 60 years (46.6% [95% CI, 42.4%-51.0%]) in the outpatient setting. Patients presenting to the ED were more often men (51.8% [95% CI, 48.7%-55.0%]) and aged younger than 45 years (aged <15 years: 16.4% [95% CI, 13.9%-18.8%]; 15-24 years: 19.2% [95% CI, 16.6%-21.7%]; and 25-44 years: 35.6% [95% CI, 32.7%-38.5%]). In nearly half of outpatient eye pain visits, the major problem was classified as nonacute (2.0 million [95% CI, 1.6 million to 2.3 million]). Eye pain was the primary reason for the visit (RFV) in 42.0% (95% CI, 37.8%-46.2%) of outpatient visits and 66.9% (95% CI, 62.9%-70.9%) of ED eye pain visits. It was the only RFV in 18.3% (95% CI, 15.0%-21.7%) of outpatient and 32.7% (95% CI, 29.0%-36.4%) of ED eye pain encounters. Ophthalmologists evaluated the largest number of outpatient visits (45.3% [95% CI, 38.8%-51.7%). The primary diagnosis was non-vision threatening for most outpatient (78.5% [95% CI, 56.8%-100%]) and ED (69.9% [95% CI, 62.1%-77.7%]) visits when eye pain was the primary RFV. Additional follow-up was scheduled in 89.4% (95% CI, 86.2%-92.6%) of visits.

Conclusions and relevance: More than 5 million eye pain visits occur annually; the largest percentage are outpatient with ophthalmologists. Most diagnoses were non-vision threatening in both the outpatient and ED setting and resulted in additional care. Expanding therapeutic approaches to treat the causes of eye pain may reduce the burden on the health care system and optimize outcomes.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Woodward reported receiving grants from National Eye Institute (R01) and grants from National Eye Institute (P30) during the conduct of the study. Dr Lee reported receiving grants from the Neuroscience Institute, being a shareholder of Pfizer stock, GSK stock, Merck stock, and Medco Health Solutions stock; and being past president of the National Alliance for Eye and Vision Research and the Alliance for Eye and Vision Research outside the submitted work. Dr De Lott reported receiving grants from the National Institutes of Health (NHI) outside the submitted work. No other disclosures were reported.

Comment on

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