Ophthalmology Volume 130, Number 12, December 2023

中文摘要

本研究旨在調查大型學術轉診中心緊急科和住院科諮詢的神經眼科病例，以瞭解諮詢模式、複雜度和最終診斷，以改進運作並優化覆蓋。研究收集了1年內所有成人（年齡> 18歲）在我們醫院經歷的神經眼科諮詢。結果顯示，這些諮詢主要來自急診和住院科，且在週末的諮詢較少。最常見的諮詢理由是視力喪失、眼球運動障礙和瞳孔異常。其中，許多病例需要多學科協調和眼科醫生的診斷和處置。本研究還發現，沒有醫療保險或擁有醫療保險的病人往往是最複雜的病例。研究結果表明，神經眼科疾病在緊急情況下需要適時的診斷和處置，並且神經眼科的需求超過了目前的提供量。為了應對這個需求，可以采取多種措施，包括改進醫療服務、設立神經眼科專科醫生，並利用遠程醫療和人工智能等技術來提高效率。

English Abstract

This article discusses the importance of prompt neuro-ophthalmology consultation in preventing diagnostic errors and improving patient outcomes. The study focuses on neuro-ophthalmology emergency department (ED) and inpatient consultations at a large academic referral center. It highlights the high demand for neuro-ophthalmology consultations, particularly in the ED, where multidisciplinary care and ancillary testing are readily available. The study analyzes the quantity of consultation requests, patterns of referrals, complexity of consultations, and final diagnoses to optimize coverage and improve operations. It also emphasizes the need for greater neuro-ophthalmology coverage, considering the limited number of neuro-ophthalmologists and the increasing number of referrals. The article suggests potential solutions such as telehealth, integrating artificial intelligence and diagnostic aids, and creating specific hospital protocols for neuro-ophthalmologic conditions. It concludes that delayed neuro-ophthalmology consultation can result in diagnostic errors, increased costs, and worse outcomes, emphasizing the importance of timely and appropriate neuro-ophthalmologic care.