Vis. Pan-Am. 2016; 15(1): 10-11.
Epidemiological profile of eye
diseases in an emergency center
complex in Campinas, Brazil
Marcelo Vicente de Andrade Sobrinho, MD1, Ana Carla Brito de Aguiar, MD 2,
Leonardo Dias Alencar, MD2, William W. Binotti, MD2, Orlando Faria Jr, MD1
Corresponding author: Marcelo Vicente de Andrade Sobrinho, MD
Rua Benjamin Constant, 1991 Cambuí – Campinas – SP CEP 13025 005
Email: [email protected]
. Ophthalmologist, Complexo Hospitalar Ouro Verde, Campinas, São Paulo State,
Brazil.
. Resident in Ophthalmology, Complexo Hospitalar Ouro Verde - Campinas - Sao
Paulo State - Brazil.
1
2
Date of submission: 15/06/2015 Date of approval: 25/09/2015
Funding: None
Proprietary/financial interes: None
ABSTRACT
Purpose: To trace the
epidemiology of eye diseases
seen in the emergency eye care
center in Campinas, Brasil.
Methods: A cross-sectional,
observational,
retrospective
survey was conducted involving
patient records assisted in the
emergency room in January of
2014. The factors analyzed were
age, gender, origin of patient and
nosological entities.
Results: A total of 1063
patients were attended. 55.9%
were male and 44.1% female.
Mean age was 37 years old.
Of this sample, 18.2% were
ocular trauma, 16.9% infectious
conjunctivitis, 7.8% keratitis, 7.6%
hordeolum, 7.5% ocular allergies,
4.7% subconjuntival hemorrhage,
3.9% blepharitis and meibomitis,
3.6% pterygium, 3.4% corneal
ulcer and 26% other diagnosis.
73.5% were from emergency eye
care admittance of our service
and 26.5% were referrals from
other services.
Conclusion:
The
most
frequent etiology was ocular trauma.
The majority of patients were male
in economically active age and their
main origin was from admittance of
emergency eye care center.
10
Key words: Epidemiology; Eye
diseases; Urgencies; Ocular trauma.
INTRODUCTION
Ophthalmological
emergencies are important causes
of worker absenteeism due to
incapacity or disability. According
to the World Health Organization
(WHO), approximately 55 million
ocular traumas per year cause loss
of working days.1-3
Thus,
the
knowledge
of the prevalence of the
ophthalmological
urgencies
provides information to plan
preventive strategies, to establish
health policies, to analyze and
direct the service where the
research is being conducted.3
The Emergency Department of
Ophthalmology of the Complexo
Hospitalar Ouro Verde (Hospital
Complex Ouro Verde) in Campinas,
São Paulo State, Brazil, attends
the free demand of patients with
ocular complaints, and also referrals
from primary and secondary units
of Campinas city and nearby cities.
Therefore, it is an important source
of data that reflects the regional
epidemiology, since there is little
information available.
This study aimed to
delineate the epidemiology
of eye diseases seen at this
Emergency Eye Care Center.
METHODS
A cross-sectional, observational,
retrospective survey was conducted.
We reviewed the charts of the
patients seen during the month
of January, 2014 at the emergency
eye care center of the Ouro Verde
Hospital Complex and studied how
many patients were attended at the
general emergency room of the
Hospital, and, of these, how many
were referred to the ophthalmology
emergency room.
Data collected included
age, which were divided in 3
groups to be comparable to
other studies analyzed (under
16 years old; between 16 and 45
years; and over 45 years), gender;
origin of referral and diagnosis
(divided in ocular trauma,
infectious conjunctivitis, keratitis,
hordeolum, ocular allergies,
subconjunctival
hemorrhage,
blepharitis and meibomitis,
pterygium and corneal ulcer).
We included foreign body in
the ocular trauma category and
did not separate open from
close ocular trauma. The lower
prevalence etiologies were
classified as other diagnosis.
This study was approved by
the Research Ethics Committee
Sobrinho MVA et al. Epidemiological profile in an emergency room.
from the Municipal Hospital Dr.
Mário Gatti, Campinas, São Paulo
State, Brazil.
The Microsoft program Excel
7, was used for processing and
analyzing the data.
RESULTS
Patients attended in the
emergency room represented
5.1% of the 20.957 patients
attended the general emergency
room. Of these, 194 had ocular
trauma (18.2%) with 132 foreign
bodies (12,4%) and 62 other
ocular traumas (5,8%); 180
infectious conjunctivitis (16.9%);
83 keratitis (7.8%); 81 hordeolum
(7.6%); 80 ocular allergies (7.5%);
50 subconjunctival hemorrhage
(4.7%); 42 blepharitis and
meibomitis (3.9%); 39 pterygium
(3.6%); 37 corneal ulcers (39.4%)
and 277 were classified as other
diagnosis (26%) (Table 1). There
were 592 male patients (55.9%)
and 466 females (44.1%).
studies have demonstrated
that the most prevalent cases
happened in young male patients
(35.4% - 43%).8-11
The high prevalence of
infectious conjunctivitis found in
this study reflects the inappropriate
use of the Hospital’s Emergency
Department, since conjunctivitis
and eyelid inflammations are
conditions that can be treated in
a primary and secondary level,
which are responsible for resolving
87.5% of the cases.4, 12
Since the creation of the public
health system in this country, the
emergency services were always
concentrated in hospitals. The flow
of these patients remains guided
by self choice, which results in
crowded emergency rooms and,
consequently, poor quality in
assistance.12,13 This study confirms the
conjecture that the lack of hierarchy
and the misuse of the public health
system still persist today.
The first group (under 16 years
old) had a total of 158 patients
(15.1%). The second group (from
16 to 45 years old) had 520 (49.7%)
and the third group (above 45
years old) had 367 (35.2%). The
lowest age in the study was one
year-old and the highest was
84 years-old. The mean age was
37±20 years-old.
In one of the studies, it was
noted that the prevailing age of
patients seeking ophthalmology
service was between 20 and 30
years.3 In other, was noted similar
age prevalence between 15
and 29 years.6 In this study, the
prevailing age was between 16
and 45 years, confirming that the
economically active population is
the most prevalent (49.6%).
Regarding the referral origin
of the patients, 766 (73.5%) were
from the emergency eye care
center admittance of our service
and 276 (26.5%) were referrals from
other locations (other hospitals in
Campinas and nearby cities).
In all the studies that
were analyzed, male patients
prevailed. 2, 3, 7, 14 Similarly, our
study showed male patients
as more predominant (56%),
although in a very close
proportion to female patients.
In general, the majority of
appointments at the emergency
department of ophthalmology are
ocular traumas and infections.1, 2, 4, 5
This may be associated with
a lower prevalence of trauma
compared to other studies, since
there is a relation between ocular
trauma with foreign body and
male gender.7
According
to
the
bibliographic research data, the
incidence of ocular trauma varied
from 21.6% to 65% worldwide.1-3,
6-9
Similarly, ocular trauma (18.2%)
was the most prevalent cause of
attendance at our emergency eye
care center followed by infectious
conjunctivitis (16.9%). Previous
Etiologies that cause red
eye forces the person in a work
environment to look for an
emergency service, whether it is
because of work security policies or
by his own will, in order to discard an
infectious-contagious or epidemic
etiology and have a medical-legal
note certifying his condition.
DISCUSSION
V I S I O N
P A N - A M E R I C A N
–
T H E
Based on that, and on the socialeconomic changes in the country,
we can presume that with greater
inclusion of women in the labor
market, there was an increase of
female patients attended at the
ophthalmological emergency rooms.
The study of prevalence in
this hospital reflects the profile of
emergency eye care in the city of
Campinas, since this emergency
room caters its own free demand
and referrals from other primary and
secondary units in Campinas and
nearby cities.
Similar to other studies, ocular
trauma (18.2%) was the most frequent
etiology, followed by a close number
of infectious conjunctivitis (16.9%).
The patients that were most prevalent
in this hospital were males in an
economically active age.
Considering that our institution
is the main venue for ophthalmology
urgencies in Campinas, this study
reflects the epidemiological profile of
urgencies in our city.
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O P H T H A L M O L O G Y