Utility of performing a cilated fundus exam in the management of uncomplicated corneal abrasions

Purpose To examine the extert to which a dilated fundus exam influences the management of uncomplicated corneal abrasions. Methods,: Cases of uncomplicated traumatic corneal abrasion were identified from a review of 5,338 consecutive Wilmer Eye ER records from January 1994 to December 1994. Cases which involved secondary orbital/periorbilal trauma, corneal laceration, penetrating injury, corneal ulcer and chemica burns were excluded. In all cases included in the study, corneal abrasion was coded as the primary diagnosis by the ER physician. Results; 500 cases of uncomplicated traumatic corneal abrasion were identified, accounting for 9.4% of all ER visits. A dilated exam was performed in 394 cases (79%) and demonstrated further pathology in 21 cases (5.3%). In no case did tie positive fundus findings alter the course of therapy in the ER setting Conclusions: A dilated exarr contributes little to the acute management of uncomplicated ccrneal abrasions and may therefore be appropriately deferred in the irterest of cost-effective and efficient patient care delivery.