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Allison Bardes, Becky Coakley, Charles Moore, Gary Jamie Miller, Judie Charlton, Denise Godin, Darra Burt, Lisa Dudley, John Nguyen; Implementation of a community vision screening program using iPads in a Carribean island country.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1554.
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© 2017 Association for Research in Vision and Ophthalmology.
Preventable causes of blindness are a major public health problem in many Caribbean countries where there is a lack of primary eye care along with insufficient eye care providers. Despite effort of medical mission programs and expansion of eye care providers training program, the needs are still unmet. In this pilot study, we aim to evaluate the effectiveness of a primary eye screening program using iPads with vision specific applications in community health centers of St. Lucia.
Community health center nurses were trained to administer screening eye examinations. Children and adults from 6 centers were prospectively entrolled from February 1 to November 30, 2015. Screening included medical history questionaire, pupillary exam, eye movements, and confrontational visual fields. Distance and near visual acuity, color vision, and formal visual fields were tested through applications on iPad. Patients who met predetermined screening criteria were referred for further evaluation. All data with the inclusion of demographics, appointment, and diagnosis were entered on iPads and sent wirelessly to the local coordinator for referral to eye care providers. The study adhered to the declaration of Helsinki for medical research and was approved by the St. Lucia Ministry of Health.
Of 454 screened patients (adults - 48.1 (+/-17.4) years with 69% female, children - 7.77 (+/-4.75) years, 41.2% girls), 208 (45.8%) were referred for further evaluation, and 140/208 (67.3%) attended referral appointments. Uncorrected refractive error was the most common diagnosis in 28.6% of referred pateints. Other diagnosis included cataract (20.7%), glaucoma (12.9%), diabetic retinopathy (5%), other (32.9%). Of 68/208 (32.7%) referred patients who did not attend referral appointments, reasons included lack of transportation, work conflict, and forgetfulness. All nurses reported high satisfaction with the use of iPads for screening due to ease of use, portability, and expedient referral.
This study underscores the high prevalence of unmet eye care needs in St. Lucia, and community health centers serve a crucial role in primary eye screening to yield a high referral attendance rate and to facilitate entrance into the eye care system of this developing country. The adoption of iPad screening programs increase accessability and earlier detection of preventable eye diseases.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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