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Pediatric ophthalmology inpatient consults at a tertiary care children's hospital
Natasha Gautam1, Radha Ram1, Eduardo Bustamante2
1Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago; Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Insights
Pediatric ophthalmology consults increased for papilledema and trauma, with abnormal eye exams found in half of cases. Consults for systemic disease and fungal infections decreased over five years.
Area of Science:
- Ophthalmology
- Pediatrics
- Hospital Medicine
Background:
- Pediatric ophthalmology inpatient consults are crucial for diagnosing and managing various ocular conditions in children.
- Understanding trends in these consults aids in resource allocation and clinical practice improvement.
Purpose of the Study:
- To analyze the 5-year pattern of pediatric ophthalmology inpatient consults at a children's hospital.
- Identify the most common reasons for consultation and associated ocular findings.
Main Methods:
- Retrospective review of all pediatric ophthalmology consult records over a 5-year period.
- Data analysis included consultation frequency, indications, and ocular examination findings.
Main Results:
- 1,805 new inpatient consultations were analyzed, with papilledema (14.18%), systemic disease workup (12.96%), and nonaccidental trauma (8.92%) as primary reasons.
- Abnormal eye examinations were noted in 50.86% of consults.
- High positivity rates for papilledema (26.56%) and nonaccidental trauma (27.95%) were observed.
Conclusions:
- Half of pediatric ophthalmology consults revealed abnormal eye examinations.
- Significant increases in consults for papilledema and nonaccidental trauma were observed.
- Decreases in consults for systemic disease workup and fungal endophthalmitis suggest evolving diagnostic patterns or improved preventative care.
Purpose:
To analyze the pattern of pediatric ophthalmology inpatient consults at a single children's hospital over 5 years.
Methods:
The records of all pediatric ophthalmology consults over a 5-year period were reviewed retrospectively.
Results:
A total of 1,805 new pediatric inpatient consultations were requested, most commonly for papilledema (14.18%), workup for unknown systemic disease (12.96%), and nonaccidental trauma (8.92%). In 50.86% of consults, an abnormal eye examination was found. When consulted for papilledema or nonaccidental trauma (NAT), we found a positivity rate of 26.56% and 27.95%, respectively. The most common ocular abnormalities noted were orbital/preseptal cellulitis (3.82%), optic disk edema (3.77%), and retinal hemorrhages (3.05%). Over the 5-year period, there was a significant increase in consults to rule out papilledema (P = 0.0001) and for trauma/nonaccidental trauma (P = 0.04) and a decrease in consults for workup of systemic disease (P = 0.03) and to rule out fungal endophthalmitis (P = 0.0007).
Conclusions:
We found an abnormal eye examination in half of our consults. When consulted for papilledema or nonaccidental trauma (NAT), we found a positivity rate of 26.56% and 27.95%, respectively.
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