{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:24:43Z","timestamp":1792178683579,"version":"4.4.0"},"reference-count":0,"publisher":"California Digital Library (CDL)","issue":"3","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["WestJEM"],"abstract":"<jats:p>Introduction: The use of the emergency department (ED) has been increasing, and many visits occur for non-urgent conditions. A similar trend was found among adult visits to the ED for ocular conditions. In this study we analyzed the impact of sociodemographic factors, presentation timing, and the COVID-19 pandemic on pediatric ED (PED) encounters for ophthalmologic conditions. It is important to identify the multifold factors associated with overutilization of the ED for non-urgent conditions. Caring for these patients in an outpatient clinical setting is safe and effective and could decrease ED crowding; it would also prevent delays in the care of other patients with more urgent medical problems and lower healthcare costs.\n\nMethods: We retrospectively reviewed electronic health records of PED ocular-related encounters at two children\u2019s hospitals before (January 2014-May 2018) and during the COVID-19 pandemic (March 2020-February 2021). Encounters were categorized based on the International Classification of Diseases codes into \u201cemergent,\u201d \u201curgent,\u201d and non-urgent\u201d groups. We analyzed associations between sociodemographic factors and degrees of visit urgency. We also compared visit frequencies, degrees of urgency, and diagnoses between pre-pandemic and pandemic data. \n\nResults: Pre-pandemic ocular-related PED encounters averaged 1,738 per year. There were highly significant sociodemographic associations with degrees of urgency in PED utilization. During the 12-month pandemic timeframe, encounter frequency contracted to 183. Emergent visits decreased from 21% to 11%, while the proportions of urgent and non-urgent encounters were mostly unchanged. The most common pre-pandemic urgent diagnosis was corneal abrasion (50%), while visual disturbance was most common during the pandemic (92%). During both time periods, eye trauma was the most frequent emergent encounter and conjunctivitis was the most common non-urgent encounter. \n\nConclusion: Sociodemographic factors may be associated with different types of PED utilization for ocular conditions. Unnecessary visits constitute major inefficiency from a healthcare-systems standpoint. The marked decrease in PED utilization and differing proportions of ocular conditions encountered during the pandemic may reflect a decrease in incidence of many of those conditions by social distancing; these changes may also reflect altered parental decisions about seeking care.<\/jats:p>","DOI":"10.5811\/westjem.2022.1.53392","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T13:26:48Z","timestamp":1653485208000},"page":"424-431","source":"Crossref","is-referenced-by-count":2,"title":["Visits to the Pediatric Emergency Department for Eye Conditions Before and During the COVID-19 Pandemic"],"prefix":"10.5811","volume":"23","author":[{"given":"Jiang","family":"Jin","sequence":"first","affiliation":[{"name":"Nemours Children\u2019s Hospital, Division of Ophthalmology, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Bules","sequence":"additional","affiliation":[{"name":"Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaynan","family":"Doctor","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital, Division of Emergency Services, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Hendricks","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital, Division of Ophthalmology, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Callaghan","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital, Department of Pediatrics, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Reid","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Division of Ophthalmology, Philadelphia,  Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Salvin","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital, Division of Ophthalmology, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Lehman","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital, Division of Ophthalmology, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Airaj","family":"Fasiuddin","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital, Division of Ophthalmology, Orlando, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jospeh","family":"Piatt","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital, Division of Neurosurgery, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29705","published-online":{"date-parts":[[2022,3,24]]},"container-title":["Western Journal of Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T13:26:49Z","timestamp":1653485209000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/4t91p6g0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,24]]},"references-count":0,"issue-title":["Western Journal of Emergency Medicine"],"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,5,11]]}},"URL":"https:\/\/doi.org\/10.5811\/westjem.2022.1.53392","relation":{},"ISSN":["1936-900X"],"issn-type":[{"value":"1936-900X","type":"print"}],"subject":[],"published":{"date-parts":[[2022,3,24]]}}}