I Feel Something in My Eye; A Retrospective Study on the Outcome of Patients with Corneal Foreign Bodies Presenting to Emergency Department

Abstract

Introduction: Extraocular foreign bodies (EOFBs) are a common presentation to the emergency department (ED). Given that inadequate management can result in severe complications including visual impairment, ED clinicians may be overly cautious and often schedule patient reviews in the ED even where it is unnecessary, placing a burden on hospital resources. Objective: This study aims to identify potential risk factors in predicting re-presentation of patients with EOFBs following ED management. This will not only help in providing better patient outcomes but also reduce the burden on hospital resources. Method: A retrospective data analysis of patients who presented to three Monash Health EDs between June and December 2016 with EOFBs was performed. Characteristics of cases where patients presented with corneal EOFBs including the size and material of EOFB, visual acuity at initial presentation and outcome of follow-ups were reviewed and analysed. Result: 123 patients presented with corneal foreign bodies, of which 3 were referred directly to the ophthalmology clinic after initial ED assessment for removal and post-removal management by ophthalmologist. 77 patients were managed in the ED and discharged with no planned reviews, of which 2 represented with complications. 31 patients were scheduled for review in ED 24 to 72 hours post-discharge, and 10 patients were referred directly to the ophthalmology clinic for follow up post ED discharge. Conclusion: The study demonstrated that the rate of re-presentation for patients with corneal foreign bodies is higher if the EOFB is metallic, the size is smaller or visual acuity is abnormal on initial presentation.