JAMA ophthalmology
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Gun violence represents a substantial public health issue, and firearm-related injuries rank second among the causes of injury-related deaths in children aged 0 to 17 years in the United States. Ocular trauma from firearm-related injuries can lead to devastating vision loss, but little is known to date about the specific demographics and characteristics of such injuries in children. ⋯ This study found that pediatric firearm-related ocular injuries from 2008 through 2014 were predominantly sight-threatening and associated with traumatic brain injury. If the possible risk factors, including sex, age, race/ethnicity, and injury intention, can be confirmed for 2015 through 2019, these findings may be useful in developing strategies to prevent pediatric firearm-related ocular injuries.
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Pharmaceutical products, including unused portions, may contribute to financial and environmental costs in the United States. Because cataract surgery is performed millions of times each year in the United States and throughout the rest of the world, understanding these financial and environmental costs associated with cataract surgery is warranted. ⋯ This study suggests that unused pharmaceutical products during phacoemulsification result in relatively high financial and environmental costs. If these findings can be substantiated and shown to be generalizable in the United States or elsewhere, reducing these costs may be of value.
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Determining the association of surgical setting and implementation of a new electronic health record (EHR) system with ophthalmic operative times is important for surgical planning and resource allocation. ⋯ The mean total OR time per case lengthened after the replacement of an EHR system in the OR, but this increase was small (shorter than 3 minutes) and limited to surgeries performed during the first 100 days after the EHR system transition. Modeling to assess surgical setting demonstrated all operative time measures were longer for cataract cases performed at the hospital outpatient department relative to those at ambulatory surgical centers. These data have implications for the fiscal and logistical management of ophthalmic surgery.
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Vision impairment (VI) and mental health conditions are highly prevalent among older adults and are major causes of morbidity and health care expenditures. However, there are few nationally representative data from the United States on the longitudinal association between VI and depressive symptoms, and no such data on anxiety symptoms. ⋯ Older US adults with self-reported VI were more likely to report symptoms of depression in the future, while those who had symptoms of either depression or anxiety were more likely to report VI in the future. This investigation suggests that there is a significant bidirectional and longitudinal association between self-reported VI and mental health symptoms. Furthermore, the study suggests the need for effective strategies to screen for and address depression and anxiety among older US adults with VI.
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Comparative Study
Cost and Visit Duration of Same-Day Access at an Academic Ophthalmology Department vs Emergency Department.
Convenient outpatient access for ophthalmology patients seeking urgent care could offer savings compared with an emergency department (ED) visit. ⋯ Same-day access appears to be less expensive and to require less time in the health care system than a visit to the ED for an ophthalmic diagnosis. Substantial savings in time and money might be achieved if urgent eye care is delivered in the clinic rather than the ED.