WHO SHOULD SEE EYE CASUALTIES - A COMPARISON OF EYE CARE IN AN ACCIDENT AND EMERGENCY DEPARTMENT WITH A DEDICATED EYE CASUALTY

Emergency care for eye complaints is provided both by accident and eme rgency (A&E) departments as well as by dedicated eye casualty departme nts. This study examines the role of each type of department and the q uality of eye care provided. Significant differences were found betwee n the accident and emergency department and the eye casualty departmen t in the history, examination and management of eye patients. Most not ably, there were significant differences in the quality of the assessm ent in the two institutions. Overall 19% (19/100) of A&E records had a n inadequate history, compared with 2% (1/50) for eye casualty records . Fifty-nine per cent (59/100) of A&E records contained a significant examination omission, compared with only 8% (4/50) of eye casualty rec ords. Most of the omissions related to a failure to perform an adequat e, yet simple, ocular examination including failure to record visual a cuity. In 44% (44-100) of A&E cases visual acuity was not recorded or recorded incorrectly. In comparison acuity omissions in eye casualty w ere present in only 4% (2/50) of cases.