Eye-Related Emergency Department Visits and The Opioid Epidemic: a 10-Year Analysis

ABSTRACT

Purpose

To describe the epidemiology of Emergency Department (ED) visits related to opioid abuse with primary ophthalmic diagnoses in the United States (US).

Methods

This retrospective cross-sectional study used National ED Sample (NEDS) (2006–2015), a representative sample of all US EDs, to analyze and compare the epidemiology of primary ophthalmic diagnoses in opioid abusers and a control group of non-opioid users. National incidence and descriptive statistics were calculated for demographics and prevalent diagnoses. Multivariable logistic regression was used to compare outcomes between primary ophthalmic diagnoses in opioid and non-opioid abusers.

Results

An estimated 10,617 visits had a primary ophthalmic diagnosis and an accompanying opioid abuse diagnosis, and the incidence increased from 0.2 in 2006 to 0.6 per 100,000 US population in 2015. Opioid abuse group had more adults (6,747:63.5%) and middle-aged (3,361:31.7%) patients, while in controls adults (7,905,003:40.4%) and children (4,068,534:20.8%) were affected more. Leading etiologies were similar: traumatic and infectious etiologies were most common; however, opioid abuse patients had more severe ophthalmic diagnoses such as orbital fractures (8.4%), orbital cellulitis (7.4%), globe injury (3.4%) and endophthalmitis (3.2%) compared to controls. Patients in the opioid abuse group were also more likely to be admitted (adjusted Odds Ratio [aOR], 28.38 [95% CI, 24.50–32.87]).

Conclusions

In the era of opioid crisis, an increase in ED visits with ophthalmic complaints is seen, with increasing direct and indirect costs on the healthcare system. More research is needed to establish causality and devise strategies to lower this burden.

KEYWORDS:

• Opioid abuse
• eye
• eye trauma
• eye infections
• ophthalmic epidemiology

Author contribution

Bushra Usmani and Sabrina Mukhtar performed literature search.

Bushra Usmani, Sohani Amarasekera, Sabrina Mukhtar and Saleema Kherani analyzed the data, performed data interpretation and statistical tests.

Bushra Usmani, Asad Latif, Mustafa Iftikhar, Deepta Raghavan, Yasir Sepah, William D. Smith, Vishal Jhanji, Kunal Dansingani and Syed Shah were involved in writing of the manuscript.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

None of the following authors have any proprietary interests or conflicts of interest related to this submission.