Comparison of pediatric and adult ophthalmology consultations in an urban academic medical center

Purpose: The purpose of this study was to compare pediatric and adult ophthalmology consultations in an urban academic center. Methods: A retrospective chart review of patients evaluated by the ophthalmology consultation service from January through June 2014 was conducted. Results: A total of 751 inpatients and emergency department patients were evaluated by the ophthalmology consultation service, of whom 152 (20.4%) were children and 598 (79.6%) were adults. The emergency department requested most of these consultations (42.8%), followed by internal medicine (39.1%) and pediatrics (18.4%) inpatients. More adult patients (94.5%) than children (76.5%) had abnormal findings on examination (P < .001). Altering management was recommended at a similar rate: 51.6% of pediatric patients and 54.3% of adult patients (P = .59). All children were initially seen by residents; children (38.6%) were more likely than adults (9.0%) to be seen with an attending physician (P < .001). Children (54.9%) were also more likely than adults (42.7%) to attend their recommended outpatient appointments (P = .027). Conclusions: The authors identified several interesting differences between the pediatric and adult consultation services. Although adult patients were more likely to have abnormal findings, the ophthalmology team recommended a change in management for more than half of each group. These rates of intervention suggest that it is equally important that children be considered for an ophthalmology consultation and examined as soon as possible. In addition, residents may need particular guidance in evaluating pediatric inpatients.