Contact Lens-Related Emergency Department Trends Identified

Women, young adults and patients with higher socioeconomic status have a greater likelihood of presenting to the emergency department (ED) with contact lens-related emergencies, according to research published in Cornea.

Researchers reviewed Nationwide Emergency Department Sample (NEDS) data from 2006 to 2017 to identify ED visits with a primary diagnosis of corneal disorder due to contact lens use. A total of 149,716 ED visits (67% women; 68.9% aged 19-44 years; 56.3% with private insurance) were used to identify populations at a high risk for complications and assess ED-related health care delivery.

Overall, southern US hospitals saw the most visits out of any US region (39.9%). Age, gender, and economic status influenced ED presentation with adolescents more likely to seek care than adults (adjusted odds ratio (aOR), 1.16; 95% CI, 1.11-1.21), women more likely to present than men (aOR, 2.12; 95% CI, 2.06-2.19), and individuals of the highest economic quartile more likely to seek treatment than those in the lowest quartile (aOR, 1.21; 95% CI, 1.15-1.27). 

A little more than half of the patients had private insurance and 20.4% had no insurance. Overall, Medicaid was the primary payer for 17.7% of patients. Patients with private or no insurance experienced a decline in ED visits between 2006 and 2017, while patients with Medicaid gradually increased over time (from 2986 patients in 2010 to 3143 patients in 2017). 

Nearly all patients with a diagnosis of corneal disorder related to contact lens were discharged from the ED (98.4%). Among those who were admitted, 65.8% (n=110) stayed for at least 1 week.

Patients who were discharged from the ED were charged $1051.4±$795.4, while those admitted were charged $26,493±$21,213.

Ocular redness or discharge, corneal ulcer, and visual disturbances were among the most common secondary eye diagnoses. The most commonly performed procedures included foreign body removal (8.4%), irrigation of the eye (2.9%), and an examination by the on-call ophthalmologist (1.6%).

“The results of our study highlight the potential burden of contact lens–related emergency department presentations,” according to the researchers. “The results of this study can be used to improve the ongoing education of patients and eye care providers regarding contact lens hygiene to reduce health care costs and prevent contact lens–related complications.”

Study limitations include a lack of data for contact lens types and best corrected visual acuity. 

Reference

Usmani B, Dayananda S, Shah S, Jhanji V. Epidemiology of contact lens-related emergency department visits: data from nationwide emergency department sample. Cornea. Published online July 5, 2022. doi:10.1097/ICO.0000000000003092