Neuro-ophthalmology Consultations in an Academic Medical Center with an Emergency Department Equipped with Nonmydriatic Fundus Imaging.
Emergency department nonmydriatic fundus imaging associated with 36% fewer in-person neuro-ophthalmology consultations.
Neuro-ophthalmology Consultations in an Academic Medical Center with an Emergency Department Equipped with Nonmydriatic Fundus Imaging.
To compare our institution's emergency department (ED) and inpatient neuro-ophthalmology consultation patterns from 2024 (after implementation of nonmydriatic ocular imaging in our general ED) with the 494 neuro-ophthalmology consultations seen in 2022 (before implementation of the camera).
Consecutive patients undergoing ED or inpatient neuro-ophthalmology consultations at a single, large, urban academic medical center.
Of 636 consecutive in-person neuro-ophthalmology consultations requested in 2024, 432 consultations (68%) were in the ED, and 204 consultations (32%) were in inpatient settings.
The most common reasons for neuro-ophthalmology consultations in the ED were concern for papilledema, other optic disc swelling, and optic neuritis.
During the same period, 241 additional patients who underwent nonmydriatic ocular imaging in the ED did not need in-person consultations either because papilledema was ruled out remotely on ocular imaging in 220 patients or because known papilledema was stable or improved on remote review of ocular imaging in 21 patients with known intracranial hypertension.
This 2-point comparison suggests an increase in total neuro-ophthalmology consultations at our academic medical center, with 36% of in-person consultations avoided since implementation of nonmydriatic ocular fundus imaging in our ED.
Implementation of nonmydriatic fundus cameras with teleophthalmology capabilities in the ED setting will be critical to address the increasing need for neuro-ophthalmic care by allowing remote consultations.