Purpose
Wills Eye Glaucoma Research Center, in cooperation with the CDC, is conducting a 2-year demonstration project to implement a community-based intervention to improve detection and follow-up eye care of individuals at high-risk for glaucoma. The project aims to 1) identify adults in underserved communities in Philadelphia most vulnerable to glaucoma (African Americans >age 50 and adults >age 60), 2) provide on-site workshops about glaucoma, 3) perform 2,000 eye exams to detect glaucoma, and 4) provide on-site treatment, follow-up, and referrals in individuals diagnosed with glaucoma, glaucoma suspect, or anatomically narrow angle.
Methods
A team of ocular technicians, health educators, and glaucoma specialists conduct exams which include 1) ocular, medical and family history of glaucoma 2) visual acuity 3) pupil exam 4) biomicroscopy of the anterior segment, 5) intraocular pressure 6) gonioscopy 7) undilated optic nerve evaluation by indirect biomicroscopy and 8) visual field testing. A total of 50 community sites, such as senior centers, community centers, housing buildings, and faith-based organizations are partnering with Wills Eye to recruit patients and conduct these exams.
Results
From January 1, 2013 to November 1, 2013, 1098 patients have been examined. Race/ethnicity data: 65% African American, 15% White, 14% Asian, and 5% Hispanic/Latino. Fifty patients (4.6%) have been diagnosed with glaucoma, 249 (22.7%) as glaucoma suspect, 126 (11.5%) with anatomical narrow angle, 71 (6.5%) with existing glaucoma, and 37 (3.4%) with other eye conditions. Individuals diagnosed with glaucoma who require treatment are recommended for selective laser trabeculoplasty (SLT), laser peripheral iridotomy (LPI), or medication. Eight individuals have completed SLT treatment and 52 have completed LPI treatment at the community site. Eighty percent of patients have scheduled follow-up appointments in the community setting and 75% of those have attended these follow-up appointments.
Conclusions
This project clearly demonstrates how a community-based intervention can improve access, detection, management, treatment, and follow-up eye care of individuals at high-risk for glaucoma. The long-term impact of this CDC-funded project aims to reduce disability, ocular health disparities, and the economic burden from vision loss due to glaucoma.