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KMID : 0360220200610121500
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Journal of the Korean Ophthalmological Society
2020 Volume.61 No. 12 p.1500 ~ p.1506
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Clinical Features of Delayed Diagnosed Acute Angle Closure Glaucoma in an Emergency Room
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Park Ji-Woong
Seo Sam
Lee Chong-Eun
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Abstract
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Purpose: To analyze the clinical features of delayed diagnosed acute angle-closure glaucoma (AACG) patients who were misdiagnosed with neurologic disease in an emergency room (ER).
Methods: This study was conducted with a total of 77 patients (77 eyes) who had been diagnosed with AACG in the ER. Age, gender, laterality, best-corrected visual acuity (BCVA) of the affected eye at the time of the ER visit and at an outpatient clinic follow-up examination, bilateral intraocular pressure (IOP) at time of visit, previous eye-disease history, previous history of ophthalmic surgery, underlying systemic disease including metabolic syndrome, previous neurologic disease history, referral source, chief complaint, past history of migraine, residence, and specialty of the initial doctor in charge of the ER were statistically analyzed.
Results: Among the 77 patients, 34 received a delayed diagnosis and 43 were diagnosed in a timely manner. Higher cases of delayed diagnosis were observed in patients who had lower BCVA at the time of the ER visit (p = 0.001), nonophthalmologic referral source visiting the ER (p < 0.001), a chief complaint of extra-ocular symptoms (p < 0.001), and a non-ophthalmologist as the initial doctor in charge of the ER (p < 0.001). None of the other factors, including IOP, previous eye-disease history, previous ophthalmic surgery, underlying systemic disease including metabolic syndrome, previous neurologic disease history, past history of migraine, or residence showed any statistically significant intergroup difference.
Conclusions: Among the AACG patients visiting the ER, many were delayed in their diagnosis and thus required much attention afterwards. Careful examination and a detailed recording of a patient’s medical history by an ophthalmologist is important for accurate and timely diagnosis in the ER.
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KEYWORD
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Acute angle closure glaucoma, Diagnostic errors, Emergency room, Headache
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