Matthew Keadey - research works

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.

Of 1838 ED visits over 16 days and nights, 182 patients (9.9%) reported vision symptoms; 162 patients (89%) underwent NMFP-OCT in the ED.

Eighty-two of 162 patients (50.6%) also underwent an in-person ED examination by an ophthalmologist.

Ocular imaging was ordered for vision loss (n = 51 [31.5%]), other visual changes (n = 13 [8.0%]), papilledema or rule out papilledema (n = 60 [37.0%]), painless red eye (n = 7 [4.3%]), eye or orbital pain (n = 28 [17.3%]), and diplopia (n = 3 [1.9%]).

For patients referred to the ED for papilledema, the ED NMFP-OCT camera reduced the median ED length of stay to 12 hours (interquartile range, 7.5-26.5 hours; 337 patients) compared with 27 hours (interquartile range, 19-33 hours; 85 patients) in 2022 (P < 0.001).

For patients with previously known idiopathic intracranial hypertension, ED stay decreased from 24 hours in 2022 (interquartile range, 12-28 hours) to 10 hours after installation of the ED NMFP-OCT camera (interquartile range, 7.5-17 hours; 50 patients; P = 0.02).