Sociodemographic and Ocular Factors Associated with Glaucoma ER Care: A Retrospective Analysis from an Eye Emergency Room

Abstract Objective: To describe the demographic factors and clinical characteristics associated with the utilization of an eye emergency room resulting in glaucoma care referral. Design: Retrospective cohort study. Subjects: All patients seen at the Wills Eye Emergency Room (ER) from October 1, 2020, to March 31, 2021, who were referred for glaucoma care. Methods and Measures: Demographic data were collected. Blindness in one or both eyes was defined as BCVA ≤20/200.1 Results: 7438 patients presented to the ER during the study period, and 192 (2.6%) were referred for glaucoma care. Of the 108 patients who provided ophthalmic history, 76 (70.4%) patients (40.8% unilaterally blind and 5.3% bilaterally blind) received a new diagnosis of definite or suspected glaucoma in the ER. 43 of 192 (22.4%) patients required urgent glaucoma procedural intervention after the ER visit; 28 (65.1%) were given a new diagnosis of definite or suspected glaucoma in the ER. 31 of 192 (16.2%) patients were uninsured; they were more likely to be younger in age (54.4 ± 14.5 years vs. 61.8 ± 15.7 years; P=0.016) and to speak a primary language other than English (16.1% vs. 5.6%; P=0.042) as compared to insured patients. Conclusion: Over a 6-month period, glaucoma represented a small subset of ER visits but resulted in a new diagnosis of definite or suspected glaucoma in the majority of cases, of whom 46.1% were unilaterally or bilaterally blind. Almost two-thirds of those with a new diagnosis required an urgent glaucoma procedural intervention after the ER visit.