Abstract
Purpose:
To present second year results of the Appalachian Vision Outreach Program (AVOP), created through the West Virginia University Eye Institute (WVU EI) to improve vision care for the underserved and socio-economically isolated populations of West Virginia.
Methods:
The Department of Health and Human Services includes in its Healthy People 2020 plan the goal that patients with a broad range of vision-threatening diseases receive yearly dilated eye exams. Because West Virginia has a high proportion of low income, underinsured, rural and older citizens with poor access to health care, medical and vision health in the state is poor. WVU EI as a part of a land grant university seeks to reduce these health disparities. WVU EI collaborated with the free clinics in WV and with the WV Lions Sight Conservation Foundation, supported by the Benedum Foundation. Screening sessions and clinical sessions were held at each free clinic in WV, a catchment area of roughly 1.5 million people. Screenings performed by AVOP personnel included an assessment of monocular distance visual acuity (VA), binocular near VA, intraocular pressure (IOP), and obtaining a history of diabetes. A general ophthalmologist staffed clinics to provide complete eye examinations on people who failed the AVOP screening or who requested a full examination. Patients needing glasses received them through the WV Lions with a $10 co-pay; those needing surgery were referred to the WV Lions for possible financial assistance. Those needing more specialized care and/or follow up were referred to a local ophthalmic professional.
Results:
We have conducted screenings and clinics at 7 locations. 441 of 642 persons failed the screening. 395 patients were referred for additional care. 248 patients had cataract, 21 of which were referred for surgery. 22 of 202 diabetic patients had retinopathy. 83 of 145 systemic hypertensive patients had vascular changes. 37 patients had high C:D ratios. 200 patients had uncorrected refractive errors. 191 pairs of glasses were provided.
Conclusions:
High levels of undiagnosed and untreated eye disease exist in people who inhabit rural, medically underserved regions of West Virginia. Data from our initial period aided AVOP in developing a model of screenings and clinics in partnership with local and state-wide organizations which has the potential to improve eye care delivery in rural environments.
Keywords: 460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower •
445 cataract •
676 refraction