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Lisa A Hark, L Jay Katz, Deiana M Johnson, Jeanne Molineaux, Jonathan S Myers, ARTHUR RESENDE, Shae Reber, Michael Waisbourd, Benjamin Leiby, Julia A Haller; Wills Eye Community Intervention to Improve Glaucoma Detection and Follow-up Care. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2588.
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© 2017 Association for Research in Vision and Ophthalmology.
The Wills Eye Glaucoma Research Center, with funding from the CDC, initiated a 5-year community-based telemedicine intervention to improve detection and management of glaucoma and other eye diseases in high-risk patients in Philadelphia.
Subjects (African Americans, Hispanic, or Asian individuals age >45; Caucasian individuals age >65; and anyone age >40 with diabetes or a family history of glaucoma) were offered eye screenings (Visit 1) in primary care physician offices and Federally Qualified Health Centers. Visit 1 consisted of an ocular, medical, and family history; fundus photographs using a non-mydriatic, auto-focus, hand-held fundus camera (Volk, Ohio, USA); intraocular pressure (IOP) measurements (iCare, Helsinki, Finland); and visual acuity testing. Subjects with abnormal images and unreadable photos were invited for a complete eye exam in the same community location (Visit 2). Satisfaction surveys were administered to all subjects at Visit 1 and analyzed independently by Westat, Inc.
From April 1, 2015 to December 1, 2015, 414 subjects consented and attended Visit 1. The mean age was 58.4 years. Subjects were predominately female (59.3%); 58% African American, 21% Caucasian, 4.1% Asian, 19.8% Hispanic/Latino and 0.8% other/mixed race. A total of 156 subjects had abnormal images (37.7%) and 62 subjects had unreadable images (15%). Fifty-three subjects (17%) had abnormal cup-to-disc ratio, 16 subjects (5.1%) had rim width <0.2 and 39 subjects (12.5%) had cup-to-disc asymmetry >0.2. Sixteen subjects (3.9%) had ocular hypertension with normal images. The majority of subjects (94%), stated they would return to this community location for a complete eye exam if a problem was found. At least 82% reported they would recommend the screening to a friend or family member and 80% said it was very convenient to have the screening in their doctor’s office.
This project clearly demonstrates how community-based telemedicine screening can improve access, detection, and follow-up eye care of individuals at high-risk for glaucoma and other eye diseases. Conducting eye screenings and complete eye examinations in primary care offices and federally qualified health centers holds promise in improving follow-up eye care and delaying vision loss in high-risk populations.
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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