April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
Detection of Non-Glaucomatous Ocular Pathology and Barriers to Follow-Up in a Community Glaucoma Detection Program
Author Affiliations & Notes
  • Wanda Deborah Hu
    Glaucoma, Wills Eye Hospital, Philadelphia, PA
  • Cindy Xin Hu
    Glaucoma, Wills Eye Hospital, Philadelphia, PA
  • Judie Tran
    Glaucoma, Wills Eye Hospital, Philadelphia, PA
  • Edward Pequignot
    Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, CA
  • Michael Waisbourd
    Glaucoma, Wills Eye Hospital, Philadelphia, PA
  • Lisa A Hark
    Glaucoma, Wills Eye Hospital, Philadelphia, PA
  • L Jay Katz
    Glaucoma, Wills Eye Hospital, Philadelphia, PA
  • Footnotes
    Commercial Relationships Wanda Hu, None; Cindy Hu, None; Judie Tran, None; Edward Pequignot, None; Michael Waisbourd, None; Lisa Hark, None; L Jay Katz, Aerie Pharm (C), Aerie Pharm (F), Alcon (C), Allergan (C), Allergan (F), Bausch & Lomb (C), Bausch & Lomb (F), Glaukos (C), Glaukos (I), Inotek (C), Merck (F), Sensimed AG (C), Sucampo (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5557. doi:
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      Wanda Deborah Hu, Cindy Xin Hu, Judie Tran, Edward Pequignot, Michael Waisbourd, Lisa A Hark, L Jay Katz; Detection of Non-Glaucomatous Ocular Pathology and Barriers to Follow-Up in a Community Glaucoma Detection Program. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5557.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: To evaluate the detection rates of non-glaucomatous ocular pathology requiring follow-up care and to identify the barriers to this follow-up care in a Centers for Disease Control and Prevention (CDC)-sponsored community glaucoma detection program.

Methods: Subjects 18 or older participated in a CDC-sponsored community-based exam to detect glaucoma throughout Philadelphia, Pennsylvania. An ophthalmologist conducted a slit lamp examination, gonioscopy, and an undilated fundus exam. Octopus® perimetry and optic nerve head photography were also performed. Subjects who were recommended for follow-up ophthalmic care at their own eye care provider for non-glaucomatous ocular pathology were also recorded. These subjects were given a telephone survey to assess rates of follow-up and to evaluate potential barriers to follow-up. Survey results were correlated with attendance of a follow-up exam using the Wilcoxon nonparametric test and Fisher’s exact test.

Results: Eight hundred and ninety-nine (899) subjects were examined from January 2013 to August 2013. One hundred three (103) subjects (11%) diagnosed with non-glaucomatous ocular pathology were recommended follow-up ophthalmic care for visually significant cataracts (6.9%), diabetic retinopathy (1.0%), macular degeneration (1.7%) and other ocular pathology (2.2%). Fifty-eight of the 103 subjects (56%) responded to the telephone survey. The average age of respondents was 58 years and females (64%) and African-Americans (69%) predominated. Of the respondents, 29% attended a follow-up appointment. Subjects who did not remember their results and recommendations were less likely to attend their follow-up appointment (p=0.036 and 0.039, respectively). Subjects’ primary language (p=0.73), education level (p=0.68), type of transportation (p=1.0), type of health insurance (p=0.18), and interval of time between their last visit to an eye specialist and the glaucoma exam (p=0.053) were not significantly associated with attending their follow-up appointment.

Conclusions: A community-based glaucoma exam is able to detect a significant amount of non-glaucomatous ocular pathology requiring further ophthalmic follow-up. However, actual follow-up rates at participants’ own eye care provider are poor and warrant the need to continue follow-up eye care at these community sites.

Keywords: 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • 463 clinical (human) or epidemiologic studies: prevalence/incidence • 460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower  

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