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Judy E Kim, Velinka Medic, Al Castro, Blanca Rodriguez, Militza Bonet, Melissa DeNomie, Zeno Franco, Veli Melih Bilen, Sally Cho, Sheikh Ahamed; Teleophthalmology in a Community Setting to Improve Eye Health Among Latinos: A Paradigm Shift. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
Despite Latinos being at high-risk for diabetes and diabetic retinopathy, many do not get eye examination to screen for retinopathy, due to a number of barriers including language, access to care, and lack of insurance. Teleophthalmology has been proposed as a way to reduce some of the barriers but most of the screenings are performed at a physician’s office or by health care personnel. In order to further reduce barriers, we assessed the feasibility and acceptance of teleophthalmology screening among Latino population at a community setting performed by bilingual community staff members.
Four community lay people were trained to take fundus photographs using a nonmydriatic camera (Daytona, Optos, NiKon, Japan) set up at a Latino community center. The images were sent via HIPAA compliant cloud system to a retinal specialist for review. The participants answered surveys regarding demographic information and their experiences with teleophthalmology screening.
During a 12 month period, 361 subjects with a mean age of 39.7 years (range: 7-90 years old) underwent teleophthalmology screening. 10% were found to have retinopathy and only 1 subject had ungradeable images. Survey was completed by 320 adults 19 years or older (mean age: 41.9). Some notable demographic information is as follows: 73% were women, 64% were from Mexico, 13% were from Puerto Rico, 54% spoke only Spanish, 64% had 12th grade or less schooling, 38% did not have health insurance and 22% never had an eye examination. While 15% had diabetes, 67% had a family history of diabetes and 93% knew that diabetes can cause eye problems. In the satisfaction survey, the percent answering "Strongly Agree" was as follows: "It was convenient to get screened at the Center", 93%; "Telemedicine helped me get more involved with my health", 71%; "I like seeing my retinal images", 83%; "I would recommend telemedicine", 88%.
It was feasible to train bilingual staff at a Latino community center to take fundus photos resulting in nearly 100% of the subjects with gradeable images using the nonmydriatic camera used in the study. Acceptance of teleophthalmology as a screening modality was high among the subjects. Teleophthalmology can be implemented in a community setting and may serve as a way to decrease barriers and improve early disease detection among Latinos.
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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