Ophthalmic consultations for incarcerated patients: An 11-year experience at a tertiary care center.

Abstract

Ophthalmic care of incarcerated individuals is understudied, particularly in the inpatient setting. We evaluated ophthalmic consultation findings, interventions and outcomes at a tertiary care center. For this retrospective noncomparative cohort study, data were collected on demographics, diagnoses, interventions, and outcomes for incarcerated patients for whom ophthalmic consultation was ordered at an academic medical center between December 2011 and December 2022. The study cohort included 163 patients (mean age = 38 years) in custody at Maryland state correctional facilities. The majority of patients were male (95.7 %) and/or Black (71.8 %). The most common reason for consultation was trauma (135 of 163, 82.8 %). Among patients presenting for trauma, the mechanism of injury was documented as assault in 117 cases (86.7 %). Among trauma patients, 56 (41 %) required surgical intervention. In total, 20 open reduction and internal fixation of orbital fractures, 11 open globe repairs, and 36 eyelid laceration repairs, as well as 3 other surgeries (anterior chamber washout, vitrectomy, and placement of an orbital implant after autoenucleation) were performed. Loss to follow-up was high; 68 patients (42 %) had no follow-up visits despite recommendations for follow-up at discharge. Ocular trauma was the most common reason for ophthalmic consultation for incarcerated patients in the hospital setting, accounting for >80 % of consults. Over 40 % of prisoners presenting for ocular trauma required surgery. Even in the custody of the state, inmates are not protected from ocular trauma. These findings suggest a need for creative, humane interventions and policy initiatives to address violence in correctional facilities.